Term
| Describe the global sx of hyperthyroidism. |
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Definition
| 1)Heat intolerance 2)Increased appetite w/ wt loss 3)Tachycardia, palpitations 4)Dyspnea 5)Hyperreflexia 6)Increased GI motility 7)Amenorrhea |
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Term
| Describe eye sx of hyperthyroidism. |
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Definition
| 1)Burning 2)Tearing 3)Lid lag 4)Prominent eyes 5)Stare 6)Eyelid tremors |
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Term
| Describe skin, nails, and hair sx of hyperthyroidism. |
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Definition
| Hair silky, nail loose and detached from nail bed, skin warm and damp |
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Term
| Which gender is hyperthyroidism MC in? |
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Definition
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Term
| What is the MC form of hyperthyroidism? |
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Definition
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Term
| A condition in which glycosaminoglycans accumulate and there is lymphoid infiltration of affected skin. |
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Definition
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Term
| Describe the skin appearance in Pretibial myxedema. |
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Definition
| Erythematous, thickened, with a rough texture |
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Term
| What is the tx for Pretibial myxedema? |
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Definition
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Term
| What Ab are increased in Grave's dz? |
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Definition
| TSH-R, ANA, anti-TPO, and anti-TG |
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Term
| what is the dx test for Grave's dz used to det. how well the thyroid absorbs iodine? |
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Definition
| High radioiodine uptake test (RAI) |
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Term
| What is the method of choice to visualize Graves opthalmopathy? |
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Definition
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Term
| What tx is used to control sx of Grave's dz (tremor, palpitations, heat intol., nervousness)? |
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Definition
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Term
| What thyroid meds are used to tx Grave's dz? |
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Definition
| Thionamides (Methimazole or PTU) |
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Term
| What age group is radioactive iodine (I-31) indicated for Grave's dz? Thyroidectomy? |
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Definition
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Term
| What med. is used to tx acute, progressive grave's opthalmopathy? |
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Definition
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Term
| What meds aggravate Grave's ophthalmopathy? |
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Definition
| Actos/Avandia. Flare often follows I-131 tx. |
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Term
| What tx is indicated for progreesive, active Grave's ophthalmopathy? |
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Definition
| Retro bulbar XRT or orbital decompression therapy |
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Term
| What other autoimmune d/o are pts w/ Grave's dz at increased risk for? |
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Definition
| Addison, alopecia recta, celiac, DM1, MG, CM |
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Term
| Describe the common pt presenting with toxic multinodular goiter. |
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Definition
| Female, >40yo w/ long-standing h/o goiter, in area deficient in Iodine |
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Term
| Are multinodular toxic goiter more often benign or malignant? |
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Definition
| 95% benign but check for CA RF (h/o head/neck XRT, fmh thryroid CA, or h/o CA) |
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Term
| Describe the possible sx of multinodular toxic goiter. |
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Definition
| Discomfort, hoarseness, dysphagia, dyspnea, SVC syndrome (facial edema, JVD) |
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Term
| What are expected lab values in multinodular toxic goiter? |
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Definition
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Term
| What imaging studies are indicated for toxic multinodular goiter? |
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Definition
| Neck US, RAI scan, and CT |
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Term
| What is the tx for multinodular toxic goiter in addition to meds used to tx Graves dz? |
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Definition
| Levothyroxine (LT4) suppression tx, minimize excessive Iodine intake |
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Term
| A condition of autonomously functioning nodules that are found MC in younger pts in Iodine deficient areas? |
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Definition
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Term
| What is the MC age of pts affected by Grave's dz? |
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Definition
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Term
| What are tx options for toxic adenoma? |
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Definition
| Propanolol for sx, thyroidectomy (<40yo) or RAI (>40yo) |
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Term
| Describe the presentation of subacute thyroiditis. |
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Definition
| Abrupt onset, usu. resolves by 8 mths, sx mimic a manic episode, Enlarged tender thyroid followed by hypothyroidism |
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Term
| Subacute thyroiditis usually follows what? |
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Definition
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Term
| Type of thyroiditis with transient inflammation. |
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Definition
| Lymphocytic or postpartum |
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Term
| What lab values are expected in thyroiditis? |
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Definition
| Elevated FT4 and thyroid Ab |
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Term
| What imaging study is used to dx thyroiditis? |
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Definition
| US (diffuse hetrogenous appearance) |
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Term
| What is another name for aubacute thyroiditis? |
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Definition
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Term
| What meds are used to tx subacute thyroiditis? |
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Definition
| Sx tx: propanolol and NSAIDS/aspirin for pain |
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Term
| Incidence of Hashimoto's thyroiditis is increased with what? |
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Definition
| Age (>60), genetics, iodine supplementation, amiodarone, exposure to head/neck external beam radiation |
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Term
| Describe the sx of Hashimotos thyroiditis. |
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Definition
| Enlarged, firm, nodular thyroid gland, depression and chronic fatigue, dry eyes/mouth |
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Term
| What is the tx for Hashimoto's? |
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Definition
| Hypo: Synthroid (thyroxine replacement) Hyper: propanolol |
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Term
| Name 3 types of tx induced hyperthyroidism? |
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Definition
| Iodine induced, Amiodarone induced, or thyroid hormone induced |
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Term
| Name 4 types of tumors that cause hyperthyroidism. |
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Definition
| 1)Metastatic thyroid CA 2)Struma ovarii (ovarian tumors that prod. thyroid hormone) 3)Trophoblastic tumors (prod HCG) 4)TSH secreting pituitary tumors |
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Term
| what is the MOA of iodides used to tx hyperthyroidism? |
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Definition
| block conversion of T4 to T3 and inhibit hormone release |
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Term
| What is the DOC of antithyroid drugs for non pregnant pts? |
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Definition
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Term
| what antithyroid drug is preferred for pregnant pts? What are AEs? |
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Definition
| Propylthiouracil (PTU). Agranulocytosis, rash, fever, GI, arthralgia. |
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Term
| What is the DOC for most pts with Grave's dz and toxic nodular goiter? |
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Definition
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