thyroid primary care I
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How does digoxin affect thyroid function?
- decreases thyroid binding globulin (TBG)
- this will alter free T4 levels
which lab meausre is the single most important measureent in the evalutiaon of thyroid disease?
which leel is the last 2 be affected in a hypothyroid person?
wha is the single most effective lab screen of thyroid function?
Free T4 index (FTI) (T7) b/c it takes into account the presence and amounts of both T4 and T3
what test is used for snthroid treatment decisions?
high TSH + Low T4=?
high low = HYPO
if you find a nodule on a thyroid what should you order?
FNA ( fine needle aspiration)
exopthalmos, what is it/
- autoimmune "bug eye" seen with Graves
- findings include: lid retraction, dry eyes, diplopia with upward and lateral extremes of gaze and lid lag
what is the most common cause of hyperthyroidism?
graves disease:causes include autoimmune, immunilogic, thryroid deficieny and toxic goiter
>age 50, long history of goider now found with multinodular goiter and presents with anorexia, weight loss and cardiac excitation (palpitations) elevated BP, lid lag over last several months what is your dx?
toxic multinodular goiter, hshimotos thyroiditis, AKA plummers disease
patient on amiodorone what lab should check during first 6 motnhs and with yearly labs/
TSH b/c it has iodine in it and can cause hyperthyroid
client in thyroidtoxicosis with RAIU increased and TSH not suppressed what should you order?
MRI r/o pituitary adenoma
what should you order for a person in a thyroidtoxicois (thyroid storm)?
- thyroid scan (radioactive iodine uptake)
what elevations or depression in labs will you find during thyroid storm?
elevated T3 and T4
thyrotoxicosis not due to hyperthyroidism , low RAIU what are some causes?
- subacute thyroditis: inflammatory response causing throxine relase. usullay following a viral syndrome may present with head and nexk pain that radiates to jaw or ear seen 2-6 months postartum.
- can be caused by exogenous synthroid.
subclinical hypo9throidism start on what does of synthroid?
name two common anti thryroid drugs (used for other problems but interfere with thyroid function)?
what are some causes of enlarged thyroid (thyrotoxicosis)?
some sort of attack on the thyroid causeing inflammation hashimotos thyroditis
- postpartum thyroditis
- subacute thyroiditis
- acute/infectious thyroiditis
what do you check to dx hashimoto's?
anti-thyroid peroxidase antibodies and or antithyroidglobulin
what test is best for determining HYPER thyroidism?
TSH (low means hyper)
with a goiter or thyroid enlargement what should you think, hyper or hypo?
can be either look at signs especialy cardiac to determine.
amiodoerone causes hyper or hypo thyroid?
amio =go (HR, BP)=HYPER
"hot nodule" is assoicated with what TSH level?
low TSH so HYPER thyroid
clinical subacute thryoditis is usually painful, can cause fever and is self limited. TRUE or FALSE?
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