hyperthyriodism

Question 1

undiagnosed thyroid disease can put pts @ risk for

Answer 1

-cardiovascular disease
-osteoporosis
-infertility
-increased mortality

Question 2

the thyroid gland

Answer 2

is a butterfly shaped organ which is found anterior to the trachea & inferior to the larynx

Question 3

thyroid tissue is composed primarily of

Answer 3

thyroid follicles, which are made up of a central cavity filled w colloid

Question 4

the colloid

Answer 4

is the center of thyroid hormone production, which is dependent on iodine

Question 5

what does the thyroid do?

Answer 5

-produces metabolic hormones which influence the body BMR
-required for protein synthesis
-fetal & childhood tissue development & growth
-support neurological functions in the body
-influence libido, fertility, & other aspects of reproduction
-increases the bodies sensitivity to catecholamines

Question 6

too much t3/t4

Answer 6

increases HR, strengthens heart beat, increases BP

Question 7

too little t3/t4

Answer 7

decreases HR, decreases BP, causes overall fatigue

Question 8

pathophysiology

Answer 8

-when the body senses too few thyroid hormones in circulation, the hypothalamus releases TRH, which stimulates the pituitary gland to release TSH
-once the TSH reaches & binds to the thyroid gland, iodine ions cross cell membranes, undergo oxidation, & through chemical processes in the colloid of the thyroid gland produce t3 & t4
-these hormones are then released into the bloodstream

Question 9

most common form is

Answer 9

graves disease

Question 10

graves disease

Answer 10

-bulging eyes
-may have goiter
-antibodies in the blood attack the thyroid gland & cause it to increase in size & secrete too much thyroid hormone

Question 11

risk factors

Answer 11

-fam hx
-more common in monozygotic twins
-environmental stressors; stress, smoking, infection, iodine exposure, post-partum

Question 12

common s/s

Answer 12

-nervousness, irritability, anxiety
-increased sweating, heat intolerance
-increased HR, BP
-hand tremors, hyperreflexia
-insomnia
-dermopathies
-thinning of hair, hair loss
-muscle weakness
-weight loss despite good appetite
-loose frequent stools
-increased energy

Question 13

diag

Answer 13

-thorough hx & physical
-EKG
-TSH, low values= negative feedback loop
-elevated free t3 & t4 &/or total t3 & t4

Question 14

to differentiate graves disease from other forms of hyperthyroidism

Answer 14

-TSH antibody tests
-radioactive iodine uptake scan
-ultrasound &/or nuclear scans to view vascularity of thyroid gland
-CT/MRI

Question 15

physical assessment

Answer 15

-thin, brittle nails
-fine, silky hair
-hyperreflexia
-weight loss
-intolerance to heat
-nervousness
-cardiac irregularities

Question 16

thyroid storm

Answer 16

very rare, but life-threatening condition that results from untreated thyrotoxicosis causing severe, sudden, & extreme symptoms

Question 17

thyroid storm s/s

Answer 17

-tachycardia
-atrial fibrillation
-fever
-syncope
-confusion
-unconsciousness
-nausea, vomiting, diarrhea

Question 18

thyroid storm can be caused by

Answer 18

-infection
-not taking meds properly
-damage or trauma to the thyroid gland
-surgery
-overgrowth of thyroid tissue
-toxic multi-nodular goiter

Question 19

thyroid storm is usually tx w

Answer 19

-meds
-potassium iodine
-beta blockers
-&/or steriods

Question 20

med management

Answer 20

beta-adrenergic blockers for pts w tachycardia

Question 21

3 options to decrease hormone synthesis

Answer 21

1. antithyroid drugs; thionamides, blocks synthesis of t3 & t4
2. 1-131 radioactive iodine tx of the gland
3. total/subtotal thyroidectomy

Question 22

side effects of antithyroid drugs

Answer 22

-neutropenia
-hepatotoxicity
-allergic reaction
-rash

Question 23

a total/subtotal thyroidectomy is recommended for pts w

Answer 23

a large goiter, compressive neck symptoms, possible cancer

Question 24

surgical tx

Answer 24

-recommended for pts w large goiters that interfere w swallowing &/or if malignancy suspected
-all or part of thyroid gland removed
-after full/partial thyroidectomy, life long thyroid hormone replacement after surgery may be required