NSG 554 EXAM GRADED A+
1. Gynecomastia causes: -Aging
-Neonatal period, puberty (tall/overweight teenagers)
-Obesity
2. Hypothyroidism: -85% women
-May be due to failure or resection of the thyroid gland itself or deficiency of pituitary
TSH
3. Goiter: -May be present with thyroiditis, iodine deficiency, genetic thyroid
enzyme defects, drug goitrogens (lithium, iodine, propylthiouracil or methimazole,
sulfonamides, amiodarone, interferon-alpha, interferon-beta, in-terluekin-2, food
goitrogens in iodine-deficient areas
* often absent in autoimmune thyroiditis
4. Hypothyroidism labs: Serum TSH - high in primary and low in secondary
hypothyroidism
Elevated in Hashimoto thyoiditis
5. Hyperthyroidism labs: Serum TSH= suppressed except in TSH-secreting
pituitary tumor or pituitary hyperplasia (rare)
,T3 uptake and scan= elevated, increased uptake
6. Subclinical hypothyroidism: Normal T4
with increased TSH may or may not have
symptoms
7. Hypothyroid Treatment: -Synthetic levothyroxine
-Average does 1.6mcg/kg/day
-Repeat TSH in 4-6 week after initiation
-TSH levels should be between 0.4-2
8. Hyperthyroidism (Thyrotoxicosis): -Clinical manifestations of
elevated T4 or T3
-Most common form is Graves Disease
9. Grave's Disease: -Most common cause of thyrotoxicosis
-Autoimmune disorder attecting the thyroid gland
-Increase in the synthesis & release of thyroid hormones
-More common in women
-Onset age 20-40
-Dietary iodine supplementation, chemotherapy can trigger
-Increased r/f systemic autoimmune dx including Sjogren, celiac, pernicious anemia,
Addison's, alopecia aerate, vitiligo, DM1, hypoparathyriodism, myasthenia gravis,
cardiomyopathy
, 10.Hyperthyroid examination findings: -Dittusely enlarged
thyroid
-Frequent asymmetric and often with bruit
-Subacute: moderately enlarged/tender, dysphagia, jaw/ear pain
-toxic multi nodular goiter: palpable nodules
-Silent thyroiditis: small nontender goiter
11. PALM-COEIN: -Polyp, adenomyosis, leiomyoma, malignancy and
hyperplasia
-Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, Not yet classified
12. Abnormal premenstrual bleeding: Laboratory studies: -CBC,
pregnancy test, thyroid tests.
-Vaginal and urine samples for PCR or culture to r/o chlamydia
13. Vaginitis: -inflammation and infection of the vagina
-caused by a variety of pathogens, allergic reactions to contraceptives or other
products, vaginal atrophy, friction during coitus
-normal pH is 4.5 or less
14. Vaginitis: Clinical findings: -vaginal irritation, pain, unusual or
malodorous discharge
-Hx including LMP, recent sexual activity, use of contraceptives, tampons, douches,
recent changes in meds or use of abx, presence of burning, pain, pruritus, profuse
discharge
15. Vaginitis: PE: -inspection of vulva
-speculum exam of vagina, cervix
1. Gynecomastia causes: -Aging
-Neonatal period, puberty (tall/overweight teenagers)
-Obesity
2. Hypothyroidism: -85% women
-May be due to failure or resection of the thyroid gland itself or deficiency of pituitary
TSH
3. Goiter: -May be present with thyroiditis, iodine deficiency, genetic thyroid
enzyme defects, drug goitrogens (lithium, iodine, propylthiouracil or methimazole,
sulfonamides, amiodarone, interferon-alpha, interferon-beta, in-terluekin-2, food
goitrogens in iodine-deficient areas
* often absent in autoimmune thyroiditis
4. Hypothyroidism labs: Serum TSH - high in primary and low in secondary
hypothyroidism
Elevated in Hashimoto thyoiditis
5. Hyperthyroidism labs: Serum TSH= suppressed except in TSH-secreting
pituitary tumor or pituitary hyperplasia (rare)
,T3 uptake and scan= elevated, increased uptake
6. Subclinical hypothyroidism: Normal T4
with increased TSH may or may not have
symptoms
7. Hypothyroid Treatment: -Synthetic levothyroxine
-Average does 1.6mcg/kg/day
-Repeat TSH in 4-6 week after initiation
-TSH levels should be between 0.4-2
8. Hyperthyroidism (Thyrotoxicosis): -Clinical manifestations of
elevated T4 or T3
-Most common form is Graves Disease
9. Grave's Disease: -Most common cause of thyrotoxicosis
-Autoimmune disorder attecting the thyroid gland
-Increase in the synthesis & release of thyroid hormones
-More common in women
-Onset age 20-40
-Dietary iodine supplementation, chemotherapy can trigger
-Increased r/f systemic autoimmune dx including Sjogren, celiac, pernicious anemia,
Addison's, alopecia aerate, vitiligo, DM1, hypoparathyriodism, myasthenia gravis,
cardiomyopathy
, 10.Hyperthyroid examination findings: -Dittusely enlarged
thyroid
-Frequent asymmetric and often with bruit
-Subacute: moderately enlarged/tender, dysphagia, jaw/ear pain
-toxic multi nodular goiter: palpable nodules
-Silent thyroiditis: small nontender goiter
11. PALM-COEIN: -Polyp, adenomyosis, leiomyoma, malignancy and
hyperplasia
-Coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, Not yet classified
12. Abnormal premenstrual bleeding: Laboratory studies: -CBC,
pregnancy test, thyroid tests.
-Vaginal and urine samples for PCR or culture to r/o chlamydia
13. Vaginitis: -inflammation and infection of the vagina
-caused by a variety of pathogens, allergic reactions to contraceptives or other
products, vaginal atrophy, friction during coitus
-normal pH is 4.5 or less
14. Vaginitis: Clinical findings: -vaginal irritation, pain, unusual or
malodorous discharge
-Hx including LMP, recent sexual activity, use of contraceptives, tampons, douches,
recent changes in meds or use of abx, presence of burning, pain, pruritus, profuse
discharge
15. Vaginitis: PE: -inspection of vulva
-speculum exam of vagina, cervix
