Term
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Definition
| colloid in center with follices aroudn rim |
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Term
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Definition
main thyroid gland product, long er half life, but not as active
predmoinantly peripehral conversion va 5 prim deiodinase,
half life of 1 day more active |
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Term
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Definition
cellular metabolism rate increased:energy unitalization
increased calcium turnover
expresison/represiosn of specific proteins
and catecholamine binding. |
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Term
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Definition
only free thyroid exerts its effects- tiny percentage of total hormone in plasma.
total hormoen level fluctuates frequently in order to keep constant free hormone levels
so total hormone concentraiton is mostly bound and inactive |
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Term
| priamry feedback inbhition of thryoid production |
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Definition
| t4, negative feedback to pituitray inhibiting tsh, and hypothalamus, inhibiting TRH. |
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Term
| main serum proteins with thryoid bound. |
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Definition
TBG- binds most t3 and t4 (more t3 is free than t4)
TBPA- lower afifnity, ready depot for readily vailale t4
albumin- sevrves as carrie when higher affinity ones are saturdated- also depot for t3 and t4 |
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Term
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Definition
t3 formation is by 5 prime deiodinating t4.
rt3 formaiton is by 5 deiodaination |
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Term
| goiter finding indicaiton |
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Definition
| can be hypo or hyperthyroidsim |
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Term
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Definition
Total T-Three, and Free t-Four.
TSH assay- IRMA. |
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Term
| Hashitmotos thyroidits antibody |
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Definition
antithyroid perxodiase antibody : aka At microsomal antibody**
anti-thryloglobulin horone has high sensitivty for autimmune disease asas well |
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Term
| pathogenetic antibody in Graves disease |
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Definition
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Term
| radioactive idoine uptaek emchanism |
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Definition
| funcitonal study of uptake in idioine, compare area of interest with background (thigh ) activity. - low in thyroiditis high in hyperthyrodiism. |
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Term
| hypothyroidism : gender prevelance and age prealence |
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Definition
| more women, pot-middle age |
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Term
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Definition
Autoimmune thryoid disease: hashimotos, or late stage garaves disease
subacute/silent thyroidits, thyroditis of pregnancy
Iatrogenic: post RAI
Drug induced: Amidoraone (forty percent iodine, excessive iodine turns of syntehsis in thyroid temporarily as a protective mechanism).
Iodine indcued,
synthetic defects ,
central hypothyroidism. |
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Term
| msot ocmmon form of hypothyroid |
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Definition
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Term
| msot ocmmon form of hypothyroid |
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Definition
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Term
| genetic componenet of hashimotos |
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Definition
| strong, overlap with graves disease |
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Term
| hashtimotos type of immnity involved |
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Definition
| cel lmediated immunity, humoral immunity not involved in pathogenesis but marks process. |
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Term
| Hashimotots thryoiditis spectrum: preclinical, subclincial, early clinical, clinical, severe late clinical |
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Definition
preclinical: only presensce of antibodies , no symtpoms, normal tsh,t4,t3 levels, not necessarily palpable glands.
Subclinical; still asympomatic no signs, now tsh is slightly elevated, ft4 and t3 aare normal due to thyroid working harder.
early clinical: TSH way up, normal T3 but ft4 has gone down (more ft4 is converted to compensate for reduced thryoid function)- pretyt much asymptomatic
clinical: TSH way up, ft4 way down, and t3 strats going down- symptmos really start
severe late clinical: now ft4 levels are basically undetectable and t3 levels are way way down. |
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Term
| Hashimotots thyroiditis speed of osnet |
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Definition
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Term
|
Definition
| loss of energy/fatigue, some weight gain, intolerance to cold, mental slowing/dementia. , hoarseness |
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|
Term
hypothyroidism clinical signs
face, skin and hair, CV, respriatory, neurolgoical, musculoskeletal, hematological |
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Definition
facies: expesionless, blunted response (neural partially mental slowness)
apathetic and puffy face- **periorbital edema
Queen anne's sign- loss of lateral eyebrows.
skin adn hair- dry/coarse skin, dry brittle hair, myxedema** (nonpitting) ,decreaed body hair.
nails dry,brittle crack
cv- slow pulse, low pulse pressuer (due to diastolci hyeprtension)
respiratory- decreased respiratory drive with effusions
GI- constipation, delayed BM,
Neurolgoical- slow, reflexes-hung up , decreased return to normal.
MS- Myopathy, arthirits
hematoligcal- Anemia. |
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Term
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Definition
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Term
| thyrotoxicosis prevalence |
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Definition
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Term
| Thyrotoxicosis definition |
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Definition
excess thryoid at tissue level.
Can occur with or WITHOUT excessive thryoid production |
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Term
|
Definition
anxiety nervousness, fatigue and weakenss, icnreased sweating and heat intolernace, hyperactivity/insomnia
palpitations fast HR, weight loss ,polyphagia, icnreasedBM and diarrhea. mEnstrual distrubances |
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Term
| thyrotoxicosis signs: vitals, facies, CV, neuro |
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Definition
icnreased respiratory rate, and icnreased pulse pressure- systolic HTN.
Facies- stare, lid lag.
systolic ejection murmur, increased s1 and s2 (prob secondary to systolic hyeprtension too).
neuro: fine resting tremor, heyprreeflexia, prox muscle weakness (increased protein breakdown). |
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Term
|
Definition
| detachment of nail from nailbed- see in thryotoxicosis |
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Term
| Diffuse thyrodial overpdocution causes |
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Definition
| grave's disease, tsh excess satates, excess b-HCG, molar pregnancy. |
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Term
| nodular thyroid disease causes |
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Definition
Multinodular goiter,
Toxic adenoma |
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Term
| thryotoxicis without hyeprthyroidism causese |
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Definition
destructive processes: Thyroidits- silent/subacute. Amiodarone induced,
Ectopic: metastitc htryoid cancer, struma ovarii
Exogenous: trhytoxicosis factitia, or iatrogenic. |
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Term
| msot common casue of thryotoxicosis |
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Definition
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Term
| Grave's disease symtpoms/signs |
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Definition
typical thryotoxicosis symtpoms.
goiter- diffuse enlargement.
opthalompathy - due to swellign in msucls aroudn robit (inflammation, antibody crossover recog.)
pretibial myxedema (graves dermopathy) |
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Term
| graves' disease typical course. |
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Definition
| varies can be waing and waning or persistent, can evolve to hashimotos with eventual hypothyroidism |
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Term
| grave's disease pathogenesis |
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Definition
| TSH receptor Ig. Can differnetially stimualte/blcok different parts of thryoid, TSH blocking Igs and TSH stimualting IGs can be present in same patient |
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Term
| CLASSIC GRAVES DISEASE TRIAD |
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Definition
| opthalomopathy, demopathy, and hyeprthyroidism |
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Term
| otphalomoatphy of graves disease |
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Definition
| due to antiobdy crossover see muscle enlargment and infalmmation ,as well as proptosis- anterior moement of the eye - periorbitaledema seen |
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Term
|
Definition
| pretibial myedema- plaques liek skin of the orange |
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Term
|
Definition
| sign of grave's disease- look like digital clubbinng. |
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Term
|
Definition
subuacte- ifnalmmatory disroder with lcoal symptoms (neck pain discormt etc), fever, and TFT changes
silent- no lcoal/systemic ifnalmmatorysymtposm , only tft changes. |
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Term
|
Definition
usually moderate elvation in Ft4 during thryotoxic phase. injury to follcile leadst o diminsihed producito and leakged ofr preformed hormone.
eentually becomes euthryoirid then hypothyroid. |
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Term
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Definition
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Term
| multinodular goiter indro |
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Definition
| thyroid follcie s heterogenous in size and function- with hot nodules (funcitonal) and lower funciton (cold). |
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Term
|
Definition
progression over years, a disease of middleag eor elderly.
TSH levels gradually go down and fT4 levels keep going up. |
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Term
| clinical presetnation of multinodular goiter |
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Definition
can be aysmptomatic diffuse goiter, dominant nodule,
can cause compression syndromes like respriatory, difficulty swallowing, hoarseness, vascular ocmpression and eurolgocial
THyrotoxicosis in elderly- typically thryotoxic, frequently precipitated by icnreasedi odine uptake or amidoarone. |
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|
Term
| tracheal compression can be caused by |
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Definition
|
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Term
|
Definition
| seeni n mutlinodular goiter, yo ussee flushing, distention of neck veis etc. when arms raised. |
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Term
| autonously fucnitonining nodule |
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Definition
| uncommo ncuase of thyrotoxicosis, gradual expansion of a signle funcitoninign nodule, leadign to elevetated t4 and t4 and supressed TSH, and hot nodule with background supression. |
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Term
| thyrotoxicosis defining feature |
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Definition
| supression of TSH! (except for tsh dependant hyeprthyroidism, occuring in tSH resistance or pituitary thyrotoroph cel ltumors. |
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|
Term
thyrotoxicosis absed on epideiolgoy and duration of symtpoms
graves disease
thyroiditis |
|
Definition
graves- younger female, family history, and prolonged history or waxing/waning.
mng- older, iodine uptake can precipitate
thyroiditis- recent URI or pregnancy, recent onset. |
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|
Term
thyrotoxicosis sorting out the cause based on exam:
difufse goiter
exophalmos /dermopathy
tender gland
nodular gland
absent goiter
severethyrotoxicosis. |
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Definition
difufse goiter- GD or TSH excess.
exophalmos /dermopathy- GD
tender gland -thyroiditis
nodular gland-MNG or hot nodule
absent goiter- facittious , silent thryoidits, could posibbly be GD
severethyrotoxicosis.- usually GD. |
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Term
|
Definition
| when characetristic ifndings of graves arent presence: i.e. need logn course OR difufse goiter, OR eye/skin findings. |
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|
Term
| if goiter present it seems that you do not need an RAIU |
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Definition
|
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Term
|
Definition
| can lead to decrased conersion of t34 to t3, with shutning to rt3 instead |
|
|
Term
|
Definition
| mass at teh base of the gonue, due to thyroid not going down embryoglogically am ybe obsturctive |
|
|
Term
| goljaN: cystic midline mass near hyoid bone |
|
Definition
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