Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Adult Health Test 3
Thyroid and Parathyroid
| Question | Answer |
|---|---|
| ____ is an imbalance of metabolism caused by the over production of thyroid hormones. | Hyperthyroidism |
| ____ is the term for the manifestations of hyperthyroidism | Thyrotoxicosis |
| _____ is a hypermetabolism affecting protein, lipid and carbohydrate metabolism | Hyperthyroidism |
| What causes increased sympathetic nerve stimulation? | Hyperthyroidism |
| Wt loss and hyperglycemia can occur as a result of ___? | Hyperthyroidism |
| Can graves disease cause hyperthyroidism? Why? | Yes, Graves disease-Toxic diffuse goiter |
| T/F Thyroid Adenoma can NOT cause Hyperthyroidism? What is Thyroid Adenoma? | False Thyroid Adenoma-Non-cancerous growths of the thyroid gland |
| Can Toxic multinodular goiter and tumors elsewhere such as testes or overies cause hyperthyroidism? | Yes |
| ____-is a inflammation due to viral infections or radiation and can cause _____? | Thyroiditis causes hyperthyroidism |
| _____-is the ingestion of excessive amounts of thyroid hormone and can cause ____? | Factitious hyperthyroidism and can cause hyperthyroidism. |
| Ingestion of excessive ____ can cause hyperthyroidism. | Iodine |
| ___is an autoimune disease...symptoms shortness of breath when laying still and perfuse sweating. | Graves disease |
| A person with ___ might experience: Heat intolerance; Diaphoresis; Thining hair; Pretibial myxedema; SOA-rapid shallow breathing; Muscle weakness and wasting. | Hyperthyroidism |
| ____ is pertruding of eyes, increased fatty tissue behind the eyes. Eyes don't close. Corneal abrasion is a worry. | Exopthalmos |
| What is a goiter? | Thyroid enlargement. You will see an enlarged neck. |
| Goiter; Exopthalmos; Lid lag; Photophobia; Irritability and restlesness; and emotional lability are all manifestations of what disorder? | Hyperthyroidism |
| HTN, Chest Pain; Palpitations; Dysrhythmias; Wt loss; uscle wasting; Fatigue & Amenorrhea are all manifestations of ____? | Hyperthyroidism |
| What do you need to teach patients with a thyroid disorder? | The manifestations of hypothyroidism and hyerthyroidism. |
| What lab results would we test for Hyperthyroidism? | Triiodothyronine (T3); Thyroxine (T4); T3 resin uptake (T3RU); THS; TSH antibodies (TSH-Rab) for graves disease |
| ___ : radioactive iodine is given by mouth or IV (RAI [1,2,3]) & the uptake by the hyroid is monitord. | Thyroid scan |
| Ultrasound,EKG, CT or MRI are also used in diagnostic testing of _____? | Thyroid disorders |
| What is Fine Needle Aspiration Biopsy? Is it Outpatient or inpatient? | A fine needle (25/27 gauge) inserted 4-7 times to obtain cells for examination. It is an Outpatient procedure that lasts about 20 min & uses local anesthetic. |
| To do a Fine Needle Aspiration Biopsy the ___ must be about 1cm. You don't need to fast or hold meds (unless blood thinning). 90% are benin. | Nodules |
| In the Thyroid scan iodine is given why? | Because thyroid needs iodide to produce hormones. |
| What should you never use in pregnant women when running a thyroid test and Why? | Never use iodide preps in pregnant women due to hurts baby thyroid. |
| Propylthiouracil (PTU)-Methimazole (Tapazole) & Carbimazole; Lithium (rarely used due to side effects) are all _______agents? | Anti thyroid agents |
| What are some types of Iodine preparations? | Strong iodine (Lugol's) solution; Saturated solution of K+ Iodide (SSK); and Potassium iodide tablets, slution or syrup |
| What do you have to be careful of when you are doing a thyroidectomy? | Work to avoid the superficial laryngeal nerve on both sides of neck. Clip one they are permanently hoarse,clip both they can't speak. |
| Following a thyroidectomy the neck is usually stiff and hurts. What do you encourage pts to do? | Move the neck |
| Post-op care of Thyroidectomy: Must really watch patients for severe _____? | Hypocalcaemia-tingling in the hands. |
| Parathyroid regulates ___ in the body and if parathyroid gets handled to much it goes into shock and ____ | Calcium; sock-stops producing hormones |
| Parathyroid hormone has a half life of ____? How many Post op surgery checks are done and when? | Parathyroid hormone has a half life of 4 hrs. 2 checks after surgery. 1 right after and another a couple of hrs later. |
| Following ___: post op care: Sore throat/difficulty swallowing; stiff neck; Check blood levels for PTH and Ca+; Bleeding; Respiratory distress; Hoarseness; and Peri-incisional numbness. | Thyroidectomy |
| ___ is life threatening: 20-25% mortality even with treatment. | Thyroid Storm |
| Signs of ___ are: fever, systolic HTN, Tachycardia, GI distress, anxiety, tremors, confusion, psychosis, seizures and coma. | Thyroid Storm |
| ____: Toxic with hyperthyroid. Usually caused by graves disease. When body gets stressed it dumps thyroid into the body, body can't keep up. | Thyroid Storm |
| T/F Pts should wear something notifying Dr.s that they have graves disease or hyperthyroidism? | True |
| Trauma/post surgical; Uncontrolled Diabetes/ketoacidosis; Pregnancy (during labor); Severe drug reaction; MI; Acute infections; RAdioactive iodine therapy/iodine load; and Vigorous palpation of a goiter can trigger a _____? | Thyroid Storm |
| T/F In emergency care you should message a goiter? | FALSE NEVER message a GOITER |
| When you think of Hyperthyroidism think of a person on a _____? | Treadmill set on high and body can't keep up with it. |
| If a person has photophobia give them ____? | Dark sunglasses |
| In Infiltrative Ophthalmopathy you should .....? | Elevate the head of the bed; use artificial tears. Tape eyes shut at night; give dark sunglasses for photophobia; some requires surgery |
| Pts who have an infiltrative ophthalmopathy can have vision loss. With surgery fatty tissue behind the eye will have _____ on ___%? | Fatty tissue behing eye-60% will have some vision improvement. Surgery will not always help with this. |
| ___ is the absent or insufficient production of thyroid hormone resulting in decreased ____? | Hypothyroidism; resulting in decrased metabolism |
| Hypothyroidism in childhood is called ___? | Creatinism |
| ____ is a mix of water and mucus? | Mixedema |
| When does Mixedema occur? Mostly Associated with? Mostly visible in ___? | Mixedema occurs in both types of hyper and hypothyroidism. It is mostly associated with hypothyroidism-most visible in puffy check arround larnax (hoarse voice) and hands |
| Low and slow is associated with ____? | Hypothyroidism |
| What are the risk factors for thyroid failure? | Family & Personal Hx of thyroid disease; Presence of antithyroid antibodies; Radiation treatment of head, neck or chest; other autoimune disease; OLD AGE |
| What are some of the medications that are risk factors for Thyroid failure? | Lithium, Amiodarone (Cordarone), Iodine |
| What is Amiodarone (Cordarone)'s half life? | 20 days |
| What is the primary cause of Thyroid Failure? | Chronic autoimmune thyroiditis |
| When treating Graves' disease...radioactive iodine therapy; subtotal thyroidectomy and Antithyroid drugs are secondary causes of _____? | Thyroid failure |
| Can a head or neck surgery cause Throid failure? | yes |
| Radiation therapy to the head, neck or chest area can cause ____? | Thyroid failure |
| Iodine deficiency; Secondary hypothyroidism (Hypopituitarism)-pituitary problem can all cause ____? | Thyroid Failure |
| What is the main reason people with Thyroid failure seek therapy? | Depression |
| Cold intolerance is assocaited with___? | Hypothyroiodism |
| Weakness, lethargy, fatigue, dry/coarse hair/brittle nails, thick tongue/hoarse voice are all manifestatons of ____? | Hypothyroidism |
| Constipation; Wt gain; mental impairment; muscle cramps/slow muscle movements; DEPRESSION/blank ecprssion; bradycardia/dysrythmias/cardiomyopathy are all manifestatoins of ______? | Thyroid failure...Hypothyroidism |
| What are the skin manifestations of Hypothyroidism? | Cool, pale or yellowish, dry, coarse, scaly skin; Thick, brittle nails; Dry, coarse, brittle hair; Decrased hair growth, with loss of eyebrow hair; POOR wound healing |
| What are the pulmonary manifestations of Hypothyroidism? | Hypoventilation, Pleural effusion, Dyspnea |
| What are the Cardiovascular Manifestations of Hypothyroidism? | Bradycardia, Dysrhythmias; Enlarged heart; Decreased activity tolerance; Hypotension |
| What are the metabolic manifestations of hypothyroidism? | Decreased basal metabolic rate; decreased body temperature; cold intolerance |
| What are the musculoskeletal manifestations of hypothyroidism? | Muscle ahes and pains; delayed contraction and relaxation of muscles |
| What are the Neurologic manifestations of hypothyroidism? | Slowing of intellectual functions; slowness or slurring of speech; Impaired memory; Inattentiveness; lethargy or somnolence; confusion; hearing loss; paresthesia (numbness & tingling) of the extremities; decreased tendon reflexes |
| Psychological/Emotional Manifestations of Hypothyroidism? | Apathy, Depression, Paranoia, withdrawal |
| Gastrointestinal Manifestations of Hypothyroidism? | Anorexia, Wt gain, constipation, abdominal distention |
| Women Reproductive manifestations of hypothyroidism? | Changes in menses (amenorrhea or prolonged menstrual periods); Anovulation; Decreased libido |
| Men reproductive manifestations of hypothyroidism? | Decreased libido and Impotence |
| Periorbital edema; face puffiness; nonpit edema-hands & feet; hoarsness; goiter; thick tongue; Increased sensitivity to opioids & trnaquilizers; weakness, fatigue; decreased urine output; anemia; easy bruising; iron/folate/Vitamin B12 deficiency..Sympt__? | Hypothyroidism |
| Edema of eyelids, face, legs (nonpitting), hearing loss, menorrhagia, slowing of return phase of reflexes (e.g. knee jerk); goiter are manifestations of ___? | hypothyroidism |
| ___ is a life threatening emergency of hypothyroidism? | Myxedema Coma |
| What is a complication of long standing or poorly treated hypothyroidism? | Myxedema Coma |
| _____ can be triggered by illness, surgery, trauma, anesthesia, hypothermia, CNS depressants, rapid thyroid medication withdrawal. | Myxedema Coma |
| The mnortality rate of ___ is 80%-occurs long standing & poorly treated. | Myxedema Coma |
| The following symptoms occur in ____: Coma; respiratory failure; hypotension; hypothermia; hyponatremia; hypoglycemia; shock, organ failure and death. | Myxedema Coma |
| What is the temperature in both F and C for hypothermia? | 75 degrees F or 24 C |
| Best practice for emergency care of Myxedema Coma....? | ABC airway breathing circulation; warm them up and give them thyroid supplements; monitor vitals (see Chart 67-6 for more details). |
| If a patient is taking thyroid replacement you want to start low and slowly build up the dose. How long will this pt be on thyroid replacement? | Lifelong treatment. |
| What do you want to teach the patient that is taking thyroid replacement? | Take the same dose, same time, every day, it is life long treatment. Don't switch brands w/o notifying the doctor. Med should be taken 1-2 hrs before giving other meds. |
| What do you monitor when a pt is taking thyroid replacement? | Monitor TSH levels because pituitary says got enough. |
| In hypothyroidism the final dose is determined by pt response and TSH levels, but if the thyroid is no longer making anything they get put on ____? | thyroid replacement therapy |
| ____ is the inflammation of the thyroid gland. | Thyroiditis |
| Name the three main types of Thyroiditis. | Chronic; Sub-acute; and Acute Thyroiditis |
| _____: Hashimoto's or autoimmune ____ is most common. | Chronic Thyroiditis: Hashimoto's or autoimmune thyroiditis is most common |
| _____: granulomatous or painful _____ after a viral infection. | Sub-acute Thyroiditis: granulomatous or painful thyroiditis after a viral infection |
| _____: rarest-due to bacterial infection | Acute Thyroiditis: rarest-due to bacterial infection |
| ____ is an autoimmune destruction of the thyroid leading to scarring and hypothyroidism. | Hashimoto's Thyroiditis |
| ____ causes enlargement of one or both lobes of the thyroid. | Hashimoto's Thyroiditis |
| ___ is diagnosed by testing TSH, thyroid hormone and anti-thyroid antibodies. | Hashimoto's Thyroiditis |
| ____ may require fine needle biopsy and is treated with thyroid hormone replacement. | Hashimoto's Thyroiditis |
| ___ is the most common cause of a painful thyroid. | Subacute Thyroiditis |
| ____ usually follows a viral infection. | Subacute Thyroiditis |
| ____ is noted for referred pain to the throat or jaw. | Subacute Thyroiditis |
| _____ is accompanied by fever, chills and painful swallowing. | Subacute Thyroiditis |
| ____ is usually identified as a single, painless, lump or nodule. | Thyroid Cancer |
| ____ is a nodule fixed to the location and does not move with swallowing. | Thyroid Cancer |
| If thyroid cancer is large it may cause ___ or ___ on swallowing? | If thyroid cancer is large it may cause hoarseness or pain on swallowing |
| ___ is diagnosed by Blood test; Thyroid scan; CT or MRI. | Thyroid Cancer |
| What is the treatment of choice for thyroid cancer? | Surgery followed by radioactive iodine is the treatment of choice. |
| It is important to tell pts what following Surgery and radioactive iodine treatment for thyroid cancer? | Sleep in another room, don't hold family cat because you are going to be radio active after surgery. Hypothyroidism now. |
| ____ acts on the kidney to increase reabsorption of calcium and increase phosphate excretion. | PTH )Parathyroid Hormone).....Hyperparathyroidism |
| 96% of ____ are due to benign adenoma of the gland. | Hyperparathyroidism |
| Parathyroid carcinoma, congenital hyperplasia, neck trauma or radiation; VITAMIN D deficiency; Chronic renal failure w/ hypocalcemia; PTH secreting tumors of other organ can all cause ____? | Hyperparathyroidism |
| Moans, groans, stones and bone is a saying for what disorder? | Hyperparathyroidism |
| What is the gartrointestinal manifestations of Hyperparathyroidism? | peptic ulcers, N/V, pancreatitis, constipation, anorexia |
| Renal-Kidney stones can occur with what? | Hyperparathyroidism |
| What are the skeletal manifestations of Hyperparathyroidism? | bone pain, osteoporosis, spontaneous fracture, weakness |
| What are the mental manifestations of hyperparathyroidism? | depression, anxiety, sleep disturbances, psychosis, coma |
| HTN and CHF can occur with ___ as well as osteoprosis. | Hyperparathyroidism |
| The following are lab results of _____: High levels of PTH along with hypercalcemia and low phosphate? | Hyperparathyroidism |
| Bone density studies; CT or Nuclear medicine scans are all diagnosis of ____? | Hyperparathyroidism |
| What are the two treatments of Hyperparathyroidism? | Surgical removal of affected gland and drug therapy to lower serum calcium levels, including fluid and diuretics, phosphates, calcitonin and calcium chelators. |
| Following a Hyperparathyroidism surgery it may take____ a few days to return to normal functioning. | a few days |
| T/F Respiratory distress from compression of the trachea by hemorrhage or swelling are all things to watch for post-op of a parathyroidectomy. | True |
| Post-op care of _____: Hypocalcemic crisis due to atropy of remaining glands-monitor calcium every 4 hrs-Trousseau's and Chvostek's. | Parathyroidectomy |
| Post-op care of ____: Watch for hoarseness and voice changes. | Parathyroidectomy |
| _____ is too little parathyroid hormone production. | Hypoparathyroidism |
| ___ is extremely rare, usually due to surgical removal of the glands | Hypoparathyroidism |
| Hypomagnesiemia is correlated with? | Hypoparathyroidism |
| Hypercalciemia depostis occur with _____ so alcoholics beware. | Hypoparathyroidism |
| Symptoms of ____ are related to hypocalcemia: tingling, muscle cramps, tetany and convulsions. | Hypoparathyroidism |
| Diagnostic test of _____ are: EEG, CT, and blood levels of calcium, Mg, phosphate and Vitamin D. | Hypoparathyroidism |
| ____ and ____ supplements are given in the treatment of Hypoparathyroiodism? ____ may also be given if needed? | Vitamin D and clacium supplements. Magnesium supplements if needed |
| The goal of ____ supplement in the treatment of hypoparathyroidism is to keep the pt in th elow normal range. High ___ can lead to kidney stones. | Calcium, Calcium |
| T/F Low calcium can lead to kidney stones. | False HIGH calcium can lead to kidney stones |
| In treating hypoparathyroidism the supplementations is ____. Pts should wear ____? | Supplementation is life long and pt should wear a med alert bracelet |
| T/F With any of the thyroid and parathyroid disorders patients should wear a med alert bracelet? | TRUE |
Created by:
cgwayland