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Patho-disorders of the thyroid
Exam 3
16
Nursing
Undergraduate 3
03/28/2011

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Cards

Term

 

disorders of the thyroid

Definition
hyperfunction: hyperthyroidism-thyrotoxicosis

hypofunction: hypothyroidism- myxedema
-aplasia- no growth of gland
-hypoplasia- low growth
-abnormal receptors

goiter-gland itself enlarged, excess or lack of iodine
Term

 

 

hyperthyroidism

Definition
a state of hypermetabolism and hyperactivity of cardiovascular and neuromuscular systems induced by high levels of circulating T3, T4, or both.
-Graves disease

etiology
-diffuse hyperplasia of the thyroid-goiter
--increased synthesis of T3 and T4
-thryoid follicular cell desctruction
--release of preformed T3 and T4
-ingestion/administration of thyroid hormone or iodide preparations
-functional thyroid neoplasms
-pituitary hypersecretion of TSH-secondary cause of hyperthyroidism
Term

 

 

graves disease

Definition
-young to middle adults
-more women affected
-familial incidence
-autoimmune

infiltration of thyroid by lymphocytes
circulating antibodies against several thyroid antigens
presence of circulating IgG(LATS)
pathogenesis of ocular disorders: inflammatory process
Term

 

graves disease:

general features

Definition
hyperthyroidism
goiter
ocular manifestations-not reversible
exophthalmos
lid retraction
ophthalmoplegia-eye muscles not working well (paralysis)
Term

 

graves disease:

clinical manifestations

Definition
behavior changes
insomnia, restlessness, palpitations, hand tremors, nervousness
heat intolerance, diaphoresis
increased body temp
increased HR and systolic pressure
fatigability, muscle weakness
weight loss, despite increased appetite
ocular manifestations
Term

 

graves disease:

thyroid storm

Definition
life threatening form of thyrotoxicosis
exagerated clinical features
-increased temp
-tachycardia and cardiac arrythmias
-congestive heart failure
-extreme restlessness, agitation, psychoses
-n/v, sever diarrhea
Term

 

hypothyroidism

Definition
congenital: cretinism
acquired
-hashimoto(lymphocytic)thyroiditis
-iodine deficiency or impeded utilization
-iatrogenic events: XRT, thyroidectomy
-goitrogen ingestion

secondary (pituitary origin)
Term

 

hypothyroidism: prevalence

Definition
older age group 60s
women more often
children-cretinism
Term

 

hypothyroidism

 

pathogenesis

Definition
-in primary hypothyroidism: autoimmune
--evidence: circulating antibodies against thyroid antigens

-in secondary: thyroid atrophy due to pituitary insufficiency
Term

 

hypothyroidism:

 

clinical manifestations

Definition
-decreased metabolism, reduced appetite
-slow mentation, speech, movement
-goiter
-skin cool and dry
-constipation
-weakness, lethargy, fatigability
-intolerance to cold
-deepened voice
-thickened tongue
-dry, thick, pale skin (carotenemia)
-coarse sparse hair
-slow heart rate, insufficiency, angina
-hypercholesterolemia
-mentrual irregularities
-advanced disease: myxedema
Term

 

hypothyroidism: myxedema

Definition
non-pitting edema
older populations
altered mental state
altered thermoregulation
history of predisposing events
myxedema coma-rare
Term

 

hypothyroidism:

 

cretinism

Definition
-occurring from birth or in early infancy
-may appear normal at birth
-abnormalities appear in a few weeks

inborn error of iodine metabolism
maternal iodine deficiency

-dwarfism
-enlarged tongue
-enlarged abdomen
-dentition delayed
-respiratory disorders
-mental deficit permanent if untreated
Term

 

 

goiter

Definition
-thyroid enlargement, with (toxic goiter) or without (simple)

-inflammatory processes (thyroiditis)
-functional disorders
-neoplasms
Term

 

goiter:

inflammatory processes

Definition
types of enlargement
-hashimoto type (struma)
--modest enlargement, nodular, symmetrical, rubbery, firm, whitish

-riedel type (struma)
--fibrotic, with potential for compression of vital organs
Term

 

goiter:

functional disorders

Definition
-decreased iodine intake-most common
-intake of goitrogenic foods
-inborn errors of metabolism

types:
-diffuse: across entire gland-more related to increased levels of TSH
-nodular: maybe only one side-focal areas of enlargement
Term

 

goiter:

neoplasms

Definition
benign tumors: follicular adenomas
malignant tumors: iatrogenic
-papillary carcinoma: generally stick around the cervical area
-follicular carcinoma: spread via the blood stream
-anaplastic carcinoma
-medullary carcinoma: rarest

usually due to something that we do to the pts, radiation, etc
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