Thyroid Disorders
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| Where is the thyroid gland located? | Lies just below the larynx with one lobe lying on either side of the trachea
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| What connects the lobes of the thyroid? | Isthmus
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| What hormones does the thyroid secrete? | *Thyroxine(T4) *Triiodothyronine(T3) *Calcitonin
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| What does the thyroid require for normal secretion of T3 and T4? | Adequate iodine intake
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| What does the thyroid regulate? | *Metabolism (main function) *Growth and development *Activity of the nervous system
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| What hormone regulates the thyroid? | Thyroid Stimulating Hormone (TSH)
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| What hormone released by the thyroid gland decreases blood calcium levels by causing calcium to be stored in bones? | Calcitonin
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| What diseases fall under hyperthyroidism? | *Graves' disease *Exophthalmic goiter *Thyrotoxicosis
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| What does hyperthyroidism result in? | exaggerated metabolic processes
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| What are the Objective S/Sx of hyperthyroidism? | *Anterior neck enlargement *Exophthalmos (bulging eyes) *Hoarse voice *Amenorrhea
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| 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
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| What is the gold standard Tx of hyperthyroidism? | Ablation Therapy with Radioactive Iodine
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| Iodine-131 is a radiation hazard to who? | Pregnant healthcare workers, and is contraindicated in pregnant PTs
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| 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
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| Surgical management of hyperthyroidism is what? | Subtotal Thyroidectomy (5/6th thyroid removed)
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| What are the most common complications of a Subtotal Thyroidectomy? | *Tetany *Hemorrhage *Edema *Thyroid Storm
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| What causes Tetany as a complication of Subtotal Thyroidectomy? | accidental removal of parathyroid gland
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| What can Tetany lead to? | Can lead to HYPOCALCEMIA, dysrhythmia, convulsions, death (Parathyroid Hormone increases serum calcium levels)
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| What are S/Sx of Tetany? | *Positive Chvostek’s Sign *Positive Trousseau’s Sign *Carpopedal spasm *Tachycardia, tachypnea, hypertension *Laryngeal spasm *Numbness or tingling
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| What is the Tx of Tetany? | IV Calcium Gluconate
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| 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
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| S/Sx of Thyroid Storm: | *Exaggerated hyperthyroidis *Severe hypertension *Tachycardia *Hyperthermia up to 106F *Cardiac dysrhythmias *Heart failure
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| Tx of Thyroid Storm: | *IV fluids *Sodium iodide and Corticosteroids *Antipyretics and oxygen as needed
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| Who does Hypothyroidism primarily effect? | women 30-60 years of age
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| What is congenital hypothyroidism called? | Cretinism
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| What are the clinical manifestations of hypothyroidism? | *Hypothermia/intolerance to cold *Weight gain *Development of atherosclerosis/CAD
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| 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
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| 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
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| What is the medical management of a goiter? | *Oral Potassium iodine *Iodine rich foods
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| What is the prognosis of Papillary thyroid cancer? | *Well-differentiated adenocarcinoma *Slow-growing *Usually contained and does not spread *High cure rate after thyroidectomy
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| What is the prognosis of follicular and anaplastic thyroid cancer? | *Rare *Very low cure rates
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| What are the clinical manifestations of thyroid cancer? | *Presence of a painless, firm, fixed nodule, palpable on examination *Rarely: symptoms of hyperthyroidism
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| What is the surgical management of thyroid cancer? | *Total thyroidectomy *Radical neck dissection with metastasis
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| What is the risk involved in needle biopsy of thyroid cancer? | Possibility of “seeding” adjacent tissue with cancer cells causing metastasis
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