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Endocrinology Thyroid 2
Endocrinology Thyroid 2
32
Science
Undergraduate 4
03/25/2009

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Term
What is the cause of hyperthyroidism and what is the name of the disease?
Definition
Grave's Disease. Autoimmune disease in in which an immunoglobulin binds to the TSH binding site and causes excessive thyroid hormone production. TSH levels are suppressed.
Term
Anti-thyroid Drug
Definition
GD is treated by reducing thyroid hormone using antithyroid drugs or by reducing the amount of thyroid tissue with radioiodine (131I) or by subtotal thyroidectomy.
Term
Thionamides
Definition
all reducing oxidation and organification of iodide. reduce thyroid antibody levels by mechanisms that remain unclear. Propylthiouracil inhibits deiodination of T4 to T3.
Term
Radioiodine treatment
Definition
causes progressive destruction ot thyroid cells and can be used as initial treatment or for relapses after a trial of antithyroid drugs.
Term
Clinical Symptoms and signs
Definition
goiter, tachycardia, warm, nervousness, increased activity, increased sweating, hypersensitivity to heat, fatigua, weight loss, insomnia, weakness, frequent bowel movements (diarrhea).
Term
What are the clinical signs and symptoms of Graves Disease
Definition
goiter, tachycardia, warm, nervousness, increased activity, increased sweating, hypersensititity, fatigue, weight loss, insomnia, weakness, frequent bowel movements. Infiltrative ophthalmopathy is characterized by increased retro-orbital tissue.
Term
Acute Thyroiditis
Definition
Bacterial infection: streptococus, enterobacter. Fungal infection: Candida. Radiation thyroiditis after 131 I treatment.
Term
Subacute Thyroiditis
Definition
viral thyroiditis, de quervains thyroiditis, silent thyroiditis.
Term
Chronic Thyroiditis
Definition
autoimmunity: focal thyroiditis, hashimotos thyroiditis, atrophic thyroiditis.
Term
What viruses have been implicated with subacute thyroidits?
Definition
Mumps, coxsackie, influenza, De Quervain's Thyroiditis.
Term
What is the pathophysiology of subacute thyroiditis?
Definition
thyroid gland generally swells rapidly and is very painful and tender. gland secretes TH and patient becomes hyperthyroid. gland quits taking up iodine and the hyperthyroidism generally resolves over the next several weeks.
Term
Clinical Sign and Symptoms of de Quervains thyroiditis
Definition
frequently become ill with fever. thyroid antibodies are not present in blood, but sedimentation rate, which measures inflammation, is very high.
Term
Treatment of de Quervains Treatment
Definition
usually bed rest and aspirin to reduce inflammation. occasionally cortisone (steroids)(to reduce inflammation) and thyroid hormone may be used in prolonged cases. nearly all recover after several weeks.
Term
What are the characterisitcs of silent thyroiditis?
Definition
rigidity and slight enlargement and pain of thyroid gland. postpartum silent often happens.
Term
Congenital Hpothyroidism
Definition
is mother has TSH-recepter blocking antibodies or has received anti thyroid drugs, leads to congenital hypothyroidism. due to thyroid gland digenesis in 80-85%.
Term
Clinical Manifestations of congenital hypothyroidism
Definition
majority of infants appear normal at birth appear normal, <10% are diagnosed based on clinical features hypotonia, enlarged tongue, delayed bone maturation, importantly, permanent neurologic damage results if treatment is delayed.
Term
How do people diagnose hpothroidism?
Definition
Small sample of blood collected from the newborn and sent for testing. one of the screening tests performed is a measurement of T4. If the T4 is low it could be a sign of hypothyroidism and further testing is done.
Term
Autoimmune hypothyroidism (Hashimotos Thyroiditis)
Definition
may be associated with a goiter. The autoimmune process gradually reduces thyroid functiton, free T4 levels fall and TSH levels rise further. It is more women than men (8:1) between 30 and 50.
Term
What is the pathogenesis of Hashimotos thyroiditis?
Definition
Marked lymphocytic infilration of the thyroid with germinal center formation, atrophy of the thyroid follicles, absence of colloid. CD4 and CD8, and B cells.
Term
What is the primary cell that destroys the thyroid in Hashimotos thyroiditis?
Definition
CD8 cytotoxic cells. local T cell production of cytokines (TNF), IL-1, and interferon gama may lead to death receptors.
Term
What are the clinical signs and symptoms of Hashimotos Thyroiditis?
Definition
goiter may not be large but irregular, skin is dry, decreased sweating, puffy face, nail groth reatded, hair is dry, constipation, weight gain, decreased libido, decreased metabolic rae, decrased heat production, decreased cadriac output, hypoventilation, mental slowness.
Term
What is the treament of Hashimotos thyroiditis.
Definition
Lifelong replacement with thyroid hormone to correct and prevent hypothyroidism.
Term
What are the relative levels of TSH and T4 in hashimotos thyroiditis?
Definition
Low T4 and elevated TSH
Term
What are the 4 major types of thyroid cancer?
Definition
papillary, follicular, medullary, anaplastic
Term
Papillary Tumors
Definition
Papillary tumors develop in cells that produce thyroid hormones containing iodine. gro very slowly from mushroom-shaped patterns. usually treatable. 60%
Term
Follicular Thyroid Tumors
Definition
develop in iodine-containing cells. have a capsule. many can be cured. 17%
Term
Medullary Tumors
Definition
Thyroid Cells, that produce a hormone that does not contain iodine. harder to control. tend to spread to other parts of the body. 5%.
Term
Anaplastic Tumors
Definition
are fastest growing thyroid tumors. Cancer cells, which are extremely abnormal, spread to other parts of the body. 18% of all thyroid cancers. Age. Sex.
Term
What is the typical treatment of Anaplastic tumors?
Definition
Thyroidectomy.
Term
What causes Euthyroiid Goiter?
Definition
inadequeate dietary intake of iodine, called endemic goiter.
Term
Clinical Signs and Symptoms of EUthyroid Goiter
Definition
elargement of the thyroid gland. T4 and T3 decreased. diagnosis gdepends on the presence of soft, symmetric smooth goiter.
Term
What is the treatment of Euthyroid Goiter?
Definition
Iodine is given. If the goiters are very large then surgery may be needed to reduce respiratory interference.
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