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33 Cards in this Set
- Front
- Back
gross findings of the thyroid....(just read)
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Two bulky lateral lobes
Connected by a thin isthmus Below and anterior to the larynx May have a pyramidal lobe/above the isthmus |
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this is the most common manifestation of thyroid disease in which a pt has a slow growing mass in the neck that is only a cosmetic problem....what is this and what is it due to?
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Goiter
iodine deficiency |
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describe a diffuse (simple) goiter
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diffuse involvement of entire gland without nodularity
- enlarged follicles are filled with colloid – colloid goiter - endemic – areas where low levels of iodine - - see in mountainous areas – Alps, Andes, Himalayas - sporadic – peak incidence in young adult - - women caused by a number of conditions – ingestion of substances that interfere with hormone synthesis (veggies & plants); hereditary enzymatic defects - - most related to iodine use |
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this is due to a long standing simple goiter and may be non-toxic or can induce thyrotoxicosis...this will produce the most extreme thyroid enlargement
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Multinodular goiter
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What is Grave's disease?
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increase 2° to hyperfunction of the gland -- hyperthyroidism
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in graves disease, what is associated with it in nearly 85% of the cases?
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Diffuse hyperplasia
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most common clinical side-effect of hyperthyroidism?
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Heart disease
increased output secondary to increased contractility and increased peripheral O2 requirements leads to tachycardia, palpitation, cardiomegaly arrhythmias---A fib |
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What Hashimoto disease?
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Autoimmune Hypothyroidism
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lithium can cause what problem in the thyroid?
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Hypothyroid
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What is Cretinism
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hypothyroidism developing in infancy or early childhood
- associated with dietary iodine deficiency & endemic goiter - associated with biosynthetic defect in hormone synthesis |
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a young child presents to your office with impaired development of the skeletal system and CNS...they have short stature, coarse facial features, protruding tongue, wide set eyes, severe mental retardation...what is going on?
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Cretinism--Hypothyroid
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pt presents with
generalized fatigue, apathy, mental sluggishness (may mimic depression in early stages), cold intolerant, frequently overweight - reduced cardiac output --> shortness of breath, decreased exercise capacity decreased sympathetic activity -->constipation, decreased sweating - skin is cool and pale - deepening of voice |
Myxedema – hypothyroidism developing in older child or adult
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gradual thyroid failure secondary to autoimmune destruction of the thyroid=?
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Hashimoto thyroiditis
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with thyroiditis there is an increased risk of what? (be specific)
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B cell lymphoma
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What is DeQuervain's disease?
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Subacute Thyroiditis
less frequent than Hashimoto, women 3 – 5:1; age 30 – 50 also called GRANULOMATOUS thyroiditis thyroid will be very tender to touch |
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what leads to DeQuervain's disease? what will a pt with it present like?
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2° viral infection or postviral inflammatory process
- Cox sackievirus, mumps, measles, adenovirus (look for previous URI leading to Patients experiencing a hyperthyroid period as the cellular lining of colloid spaces fails, allowing abundant colloid into the circulation, with neck pain and fever. Patients typically then become hypothyroid as the pituitary reduces TSH production and the inappropriately released colloid is depleted before resolving to euthyroid) Remember: this is subacute thyroiditis, also known as granulomatous thyroiditis; it will be very tender to touch |
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this problem is uncommon and of unknown etiology. It is a fibrosing process--thyroid through the capsule into the contiguous neck structures. Can have gland atrophy and resulting hypothyroidsim...what is this?
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Riedel Thyroiditis
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>90% of thyroid neoplasms are what?
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Adenomas
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Adenomas are the most common thyroid neoplasm...are these likely to become cancer?
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NO
rarely precursors of cancer |
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woman comes to your office saying they felt a little nodule on their neck upon palpation you find the nodule and a mass in the cervical lymph nodes...what should you be thinking
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Papillary ca (thyroid neoplasm)
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what is the most common congenital lesion of the thyroid?
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thyroglossal duct cyst
a remnant of the tubular development of the thyroid may present at any age – midline cyst or mass anterior to trachea often significant lymphocyte infiltrate rare transformation to ca |
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Parathyroid glands are derived from
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pharyngeal pouches
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activity of parathyroid is controlled by what?
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controlled by level of free ionized calcium in blood
decreased levels of ionized calcium stimulate synthesis & secretion of PTH |
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if you suspect a problem with the parathyroid what should you order?
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free ionized calcium
decreased levels of ionized calcium stimulate synthesis & secretion of PTH |
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what normally causes primary hyperparathyroidism? leads to?
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Adenoma
leads to hypercalcemia |
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how can you distinguish hypercalcemia due to parathyroid and nonparathyroid disease?
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serum PTH levels are low to undetectable in hypercalcemia from nonparathyroid disease
whereas it would be really high in primary |
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what is the most common cause of secondary hyperparathyroidism?
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Renal failure
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major cause of hypoparathyroidism?
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Surgical removal of the gland
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DiGeorge syndrome can lead to what endocrine issue?
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Hypoparathyroidsim--hypocalcemia
CATCH 22 |
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tetany, muscle cramps and convulsions are due to what?
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hypoparathyroid
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symptoms of hypoparathyroidism
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neuromuscular – tetany, muscle cramps, convulsions
mental status – irritability, psychosis intracranial – Parkinsonian-like movement disorders, intracranial pressure & papilledema ocular changes – calcification of lens, cataract formation cardiac – conduction defects which produce prolongation of QT interval |
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pt presents with short stature, round face, short neck, and short metacarpals/tarsals...what is going on?
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Pseudohypoparathyroidism
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what clinical feature shows up early on with hypoparathyroidism?
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TETANY
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