Test Your Knowledge 2

Question 1

Name some common NM manifestations of Graves’ disease

Answer 1

• Chronic periarthritis and calcific arthritis, usually in the shoulder
• Proximal muscle weakness

Question 2

Graves’ disease: What can chronic periarthritis and calcific arthritis progress to?

Answer 2

Adhesive capsulitis

Question 3

Graves’ disease: What is chronic periarthritis and calcific arthritis characterized by?

Answer 3

• pain

- reduced ROM

Question 4

Proximal muscle weakness with Graves’ disease is most significant here

Answer 4

• pelvic girdle
• thigh

*atrophy

Question 5

What are the 3 major types of medical tx for hyperthyroidism?

Answer 5

• radioactive iodine (RAI)
• Antithyroid agents
• Thyroidectomy

Question 6

Which thyroid tx is most commonly used for pts under 12 or pregnant?

Answer 6

Antithyroid agents

Question 7

Which thyroid tx is the first choice for those under 18?

Answer 7

Radioactive iodine (RAI)

Question 8

How long does it take for RAI tx to be effective?

Answer 8

Several months

Question 9

What is a thyroid storm?

Answer 9

Acute episode of thyroid overactivity

Question 10

Describe what an episode of thyroid storm would look like

Answer 10

• high fever (105˚)
• severe tachycardia
• delirium
• dehydration
• agitation

Question 11

What does a thyroid storm require?

Answer 11

IMMEDIATE MEDICAL REFERRAL

Question 12

What is more common, hyper or hypothyroidism?

Answer 12

Hypothyroidism

Question 13

What is cretinism?

Answer 13

Hypothyroidism present in fetal development

Question 14

What does cretinism usually result from?

Answer 14

• absent thyroid tissue

- hereditary defects in thyroid hormone synthesis

Question 15

Why is it important that cretinism be identified and addressed promptly?

Answer 15

• the brain is still developing at that point

- cognitive damage not likely to be reversible, but physical defects can be

Question 16

How is hypothyroidism classified?

Answer 16

Type 1: primary (hormone deficient)

Type 2: secondary (hormone resistant)

Question 17

Which type of hypothyroidism is the most common?

Answer 17

Type 1: primary (hormone deficient)

Question 18

Hypothyroidism:

Type 1: primary (hormone deficient)

Answer 18

• Reduced function of thyroid tissue or

- impaired hormonal synthesis

Question 19

Hypothyroidism:

Type 2: primary (hormone resistant)

Answer 19

inadequate stimulation of gland due to dysfunction of

• pituitary
• hypothalamus

Question 20

Describe the pathogenesis of hypothyroidism

Answer 20

• loss of thyroid tissue »
  » decreased secretion of thyroid hormone »
  » TSH secretion is increased from anterior pituitary to attempt to stimulate production of thyroid hormone »
  » thyroid unable to respond fully to TSH, so not enough T3 and T4 reach organs »
  » pituitary continues to release more TSH (trying to stimulate)»
  » Increased TSH levels in the blood

Question 21

What is the result of increased TSH in the blood?

Answer 21

• Bradycardia
• Decreased GI motility
• Slowed neurogenic function
• Decreased body heat production
• Increased serum cholesterol and triglycerides
• Potential for anemia

Question 22

What does increased serum cholesterol and triglycerides result in?

Answer 22

• arteriosclerosis

- CAD

Question 23

What is the most commonly used medical test to diagnose functional thyroid dysfunction?

Answer 23

TSH test (easy and cheap)

Question 24

Which tests are used to corroborate the results of the TSH test for functional thyroid dysfunction?

Answer 24

T3 and T4 tests