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68wm6 p2 Thy Dis

Thyroid Disorders

Where is the thyroid gland located? Lies just below the larynx with one lobe lying on either side of the trachea
What connects the lobes of the thyroid? Isthmus
What hormones does the thyroid secrete? *Thyroxine(T4) *Triiodothyronine(T3) *Calcitonin
What does the thyroid require for normal secretion of T3 and T4? Adequate iodine intake
What does the thyroid regulate? *Metabolism (main function) *Growth and development *Activity of the nervous system
What hormone regulates the thyroid? Thyroid Stimulating Hormone (TSH)
What hormone released by the thyroid gland decreases blood calcium levels by causing calcium to be stored in bones? Calcitonin
What diseases fall under hyperthyroidism? *Graves' disease *Exophthalmic goiter *Thyrotoxicosis
What does hyperthyroidism result in? exaggerated metabolic processes
What are the Objective S/Sx of hyperthyroidism? *Anterior neck enlargement *Exophthalmos (bulging eyes) *Hoarse voice *Amenorrhea
What are the subjective S/Sx of hyperthyroidism? *Decreased ability to concentrate, presence of memory loss *Dysphagia *Weight loss even with increased appetite *Complaint of nervousness, jittery, excitable *Insomnia *Emotionally labile, may overreact to stress
What is the gold standard Tx of hyperthyroidism? Ablation Therapy with Radioactive Iodine
Iodine-131 is a radiation hazard to who? Pregnant healthcare workers, and is contraindicated in pregnant PTs
What are the adverse effects of ablation therapy? *CHRONIC HYPOTHYROIDISM *Abdominal pain; nausea/vomiting/diarrhea sore throat; neck pain and edema *Rash; pruritis *Loss of taste
Surgical management of hyperthyroidism is what? Subtotal Thyroidectomy (5/6th thyroid removed)
What are the most common complications of a Subtotal Thyroidectomy? *Tetany *Hemorrhage *Edema *Thyroid Storm
What causes Tetany as a complication of Subtotal Thyroidectomy? accidental removal of parathyroid gland
What can Tetany lead to? Can lead to HYPOCALCEMIA, dysrhythmia, convulsions, death (Parathyroid Hormone increases serum calcium levels)
What are S/Sx of Tetany? *Positive Chvostek’s Sign *Positive Trousseau’s Sign *Carpopedal spasm *Tachycardia, tachypnea, hypertension *Laryngeal spasm *Numbness or tingling
What is the Tx of Tetany? IV Calcium Gluconate
What is Thyroid Storm and when does it occur? *Over-release of thyroid hormone in the blood stream *Appears within 12 hours post-op of subtotal thyroidectom
S/Sx of Thyroid Storm: *Exaggerated hyperthyroidis *Severe hypertension *Tachycardia *Hyperthermia up to 106F *Cardiac dysrhythmias *Heart failure
Tx of Thyroid Storm: *IV fluids *Sodium iodide and Corticosteroids *Antipyretics and oxygen as needed
Who does Hypothyroidism primarily effect? women 30-60 years of age
What is congenital hypothyroidism called? Cretinism
What are the clinical manifestations of hypothyroidism? *Hypothermia/intolerance to cold *Weight gain *Development of atherosclerosis/CAD
What are subjective S/Sx of hypothyroidism? *Impaired memory, slow thought processes *Depression or paranoia *Lethargy, forgetfulness, and irritability *Anorexia and constipation *Decreased libido and reproductive difficulty *Menstrual irregularities *Speech and hearing impairments
What causes goiter? *Lack of Iodine in diet (most common) *PT unable to utilize iodine properly *Blood level of T3 is too low to signal the pituitary to decrease TSH secretion
What is the medical management of a goiter? *Oral Potassium iodine *Iodine rich foods
What is the prognosis of Papillary thyroid cancer? *Well-differentiated adenocarcinoma *Slow-growing *Usually contained and does not spread *High cure rate after thyroidectomy
What is the prognosis of follicular and anaplastic thyroid cancer? *Rare *Very low cure rates
What are the clinical manifestations of thyroid cancer? *Presence of a painless, firm, fixed nodule, palpable on examination *Rarely: symptoms of hyperthyroidism
What is the surgical management of thyroid cancer? *Total thyroidectomy *Radical neck dissection with metastasis
What is the risk involved in needle biopsy of thyroid cancer? Possibility of “seeding” adjacent tissue with cancer cells causing metastasis
Created by: Shanejqb