Term
| What are some key steps in the formation of thyroxine |
|
Definition
Sodium-Iodine Symport
Thyroperoxidase
Deiodiodinase |
|
|
Term
| What is the majority of thyroid hormone released from the thyroid gland composed of, and how does it circulate in the blood |
|
Definition
| T4, circulates mostly bound to TBG |
|
|
Term
| What is the activated form of Thyroid hormone and how does it become activated |
|
Definition
| T3, activated by deiodination in periphery |
|
|
Term
| How does thyroid hormone induce peripheral tissues |
|
Definition
| Amino acid hormone that acts at a Nuclear receptor like steroids |
|
|
Term
| What are some signs that would make you suspicious of hypothyroidism? |
|
Definition
Cold intolerance
Skin changes
Alopecia
Psych changes
Weakness |
|
|
Term
| What are some things to be cognisant of in using TSH screening test |
|
Definition
Pregnancy
Pituitary Disease |
|
|
Term
| What would the TSH and T4 level be in primary verses secondary hypothyroidism |
|
Definition
Primary: High TSH, Low T4
Secondary: Low TSH, Low T4 |
|
|
Term
| What is the clinical manifestation of untreated congenital hypothyroidism and why is it screened for? |
|
Definition
Cretinism
Mental retardation occurs if untreated |
|
|
Term
| What are some common medications that can lead to hypothyroidism |
|
Definition
Amiodarone
Lithium
Interferon Alpha |
|
|
Term
| Does high antibody against thyroid proteins lend a diagnosis of Hashimotos alone? |
|
Definition
| No, many euthyroid patients have these ABs |
|
|
Term
| How is hypothyroid screening carried out |
|
Definition
| TSH screen, if positive then TSH and T4 are screened |
|
|
Term
| What is the standard hypothyroid treatment and what are other less used options |
|
Definition
Oral Levothyroxine
Less common: Combo T3/T4, Armour Thyroid |
|
|
Term
| What patients should you be wary of begining a higher dose of T4 initially |
|
Definition
Very Old
CV Disorder Patients |
|
|
Term
| How would you monitor the treatment of a primary versus secondary hypothyroid patient differently? |
|
Definition
Primary: TSH
Secondary: T4 |
|
|
Term
| What are the clinical complications of Myxedema Coma? |
|
Definition
CV collapse
Hyponatremia
Respiratory Failure
Hypothermia |
|
|
Term
| What is the treatment of Myxedema coma |
|
Definition
| IV levothyroxine and IV glucocorticoids |
|
|
Term
| What would be the reasons to get a ultrasound on a hypothyroid patient? |
|
Definition
| Goiter, or thyroid nodule on PE |
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