Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine Week 3 2017/18 > 1: Hyperthyroidism, hypothyroidism and thyroiditis > Flashcards

1: Hyperthyroidism, hypothyroidism and thyroiditis Flashcards

1
Q

Thyroid disease can be ___ or ___.

A

primary , secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a goitre?

A

Lump in the thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Primary thyroid disease is usually ___.

A

autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Secondary thyroid disease is usually caused by disease of which glands?

A

Hypothalamus

Pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which hormone is released from the anterior pituitary gland and affects the function of the thyroid gland?

A

Thyroid stimulating hormone (TSH)

also known as thyrotropin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TSH is also known as ___.

A

Thyrotropin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the two hormones produced by the thyroid gland?

A

T3

T4

“thyroxines”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

99% of T3 and T4 is bound to what?

A

Transport proteins

Thyroxine binding globulin

Albumin

Pre-albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which hormone, produced by the hypothalamus, triggers the anterior pituitary’s production of TSH?

A

Thyrotropin releasing hormone (TRH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The hypothalamic-pituitary-thyroid axis is controlled by ___ feedback.

A

negative feedback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What happen to the levels of free T3/T4 and TSH in

a) primary hypothyroidism
b) primary hyperthyroidism?

A

a) Primary hypothyroidism - free T3/4 LOW, TSH HIGH

b) Free T3/4 HIGH, TSH LOW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In secondary hypothyroidism, is TSH raised?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Secondary hyperthyroidism is very rare. What are the levels of T3/4 and TSH?

A

Everything is high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is hypothyroidism?

A

Insufficient secretion of thyroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is severe hypothyroidism also known as?

A

Myxoedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a rare sign of Graves disease, which itself causes hyperthyroidism?

A

Pretibial myxoedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hypothyroidism is very (common / uncommon).

A

common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Reduced intake of what can cause hypothyroidism?

A

Iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hypothyroidism is categorised by the presence or absence of a…

A

goitre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is an autoimmune cause of hypothyroidism which presents with a goitre?

A

Hashimoto’s thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What occurs in Hashimoto’s thyroiditis?

A

Auotimmune destruction of thyroid gland

Reduced thyroid hormone secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hashiomoto’s thyroiditis is more common in (men / women).

A

women

As with all autoimmune disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What antibodies are seen in Hashimoto’s disease?

A

Thyroid peroxidase antibodies (TPO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is seen histologically in Hashimoto’s disease?

A

T cell infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why are the symptoms of thyroid disease so diverse?

A

Systemic impact of hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is seen in the hair and skin of someone with hypothyroidism?

A

Coarse, sparse hair

Expressionless, puffy face

Pale, cold skin

Vitiligo

Hypercarotenaemia (orange skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

People with hypothyroidism will complain of being very (hot / cold).

A

cold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is seen in the ankles of people with hypothyroidism?

A

Pitting oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some cardiovascular complications of hypothyroidism?

A

Bradycardia

Cardiac dilatation

Effusions

Hyperlipidaemia (inc. xanthelasma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

People with hypothyroidism have a REDUCED appetite - what happens to their weight?

A

They gain weight anyway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which systems does hypothyroidism also affect?

A

GI

Resp

Neuro

32
Q

In primary hypothyroidism, you see (high / low) levels of TSH and (high / low) levels of T3/4.

A

high TSH (body trying to compensate)

low thyroid hormones

33
Q

Which autoantibodies are raised in

a) Autoimmune hypothyroidism in general (Hashimoto’s)
b) Graves disease?

A

Hashimoto’s - anti-TPO

Graves - TSH receptor

34
Q

How is hypothyroidism managed?

A

Levothyroxine tablets

25-100 µg

35
Q

In primary hypothyroidism, levothyroxine dose is tailored to the levels of what?

A

TSH

36
Q

What is levothyroxine also known as?

A

T4

37
Q

When should patients take their levothyroxine?

A

Before breakfast

38
Q

Why is levothyroxine taken before breakfast?

A

Food, drugs affect its absorption

e.g PPIs

39
Q

Pregnant women require (higher / lower) doses of levothyroxine.

A

higher

40
Q

What is an emergency associated with untreated hypothyroidism?

A

Myxoedema coma

41
Q

Myoxedema coma is seen in ___ patients with untreated hypothyroidism.

How do they present?

A

elderly

Bradycardia, heart block

Respiratory failure

42
Q

What is

a) hyperthyroidism
b) thyrotoxicosis?

A

Hyperthyroidism - overproduction of thyroid hormones by thyroid gland

Thyrotoxicosis - state caused by excess thyroid hormone

43
Q

What does thyrotoxicosis look like?

A

Cardiac symptoms - palpitations, AF

Tremor

Sweating

Anxiety, nervous, irritable, insomnia

44
Q

How do the bowel movements change in thyrotoxicosis?

A

Frequent, loose stools

45
Q

What is a distinct facial presentation of thyrotoxicosis?

A

Lid retraction

Double vision

Bulging eyes (proptosis)

46
Q

What is the most common cause of thyrotoxicosis?

A

Hyperthyroidism caused by Graves disease

47
Q

Apart from Graves disease, what else causes hyperthyroidism?

A

Thyroid nodules

act independently, don’t respond to hypothalamic / pituitary axis and are toxic

48
Q

Not all thyrotoxicosis is caused by hyperthyroidism. What else can cause it?

A

Thyroiditis - de Quervain’s, post-partum and drug-induced (e.g amiodarone)

Levothyroxine overdose - thyrotoxicosis factitia

Ectopic thyroid tissue i.e metastasis of thyroid cancer

49
Q

Graves disease causes (hyper / hypo)thyroidism and is more common in (men / women).

A

hyperthyroidism

women

50
Q

What lifestyle factor is thought to be involved in the onset of Graves disease?

A

Smoking

51
Q

In Graves disease, what changes are seen in

a) TSH
b) T3/4 levels?

A

a) TSH decreases (to compensate for hyperthyroidism)

b) T3/4 increases (overproduction)

52
Q

What bone issues are seen in Graves disease?

A

Osteoporosis

so hypercalcaemia and increased ALP

53
Q

What antibody is raised in Graves disease?

A

TSH receptor antibody

note that it’s not an AUTOANTIBODY - stimulates cells rather than getting them destroyed

54
Q

What is a rare sign of early Graves disease?

A

Pre-tibial myxoedema (which is confusing bc myxoedema means hypothyroidism)

55
Q

What general sign is sometimes seen in Graves disease?

A

Specific type of finger clubbing called THYROID ACROPACHY

56
Q

What can sometimes be heard on auscultation of a thyroid of someone with Graves disease?

A

Bruit

57
Q

Graves disease causes serious ___ disease.

A

eye

58
Q

Apart from Graves disease, what other thyroid disease can cause thyrotoxicosis?

A

Nodular thyroid disease

59
Q

What does the goitre look like in

a) Graves disease
b) Nodular thyroid disease?

A

a) Grave’s goitre is symmetrical and smooth

b) Nodular goitres are… nodular and asymmetrical

60
Q

What does a thyroid function test look like in nodular thyroid disease?

A

TSH decreases

T3/4 increases

61
Q

Are people with nodular thyroid disease positive for TSH receptor antibody?

A

No

62
Q

What is an emergency which can occur in people with untreated hyperthyroidism?

A

Thyroid storm

63
Q

What does thyroid storm present as?

A

Respiratory and cardiac collapse

Hyperthermia

64
Q

How is thyroid storm treated?

A

Cooling

Inhibition of thyroid gland with potassium iodide

Beta blockers to control sympathetic symptoms

65
Q

How is hyperthyroidism treated?

A

Antithyroid drugs

66
Q

What is an example of an antithyroid drug?

A

Carbimazole

67
Q

What are some side effects of antithyroid drugs?

A

Skin reactions

Liver disease

AGRANULOCYTOSIS - neutrophils cannot produce granules to fight infection

68
Q

What is the presentation of agranulocytosis?

A

Fever

Infection of mouth and throat

69
Q

If patients develop agranulocytosis after taking an antithyroid drug, can they start using them again?

A

No

70
Q

Which beta blocker is used in people with hyperthyroidism?

A

Propranolol

71
Q

What is a possible side effect of propranolol?

A

Bronchospasm in patients with asthma

72
Q

If a patient’s asthma worsened after taking propranolol for their hyperthyroidism, what would you give them instead?

A

CCB e.g diltiazem

73
Q

If a patient’s Graves disease / nodular thyroid disease relapses after stopping drugs, what would you try instead?

A

Radioiodine

74
Q

Can radioiodine be given to pregnant women?

A

No

75
Q

What do patients have to be advised about if they are on radioiodine?

A

Contact with other people - their necks are radioactive

76
Q

If both drugs and radioiodine have failed in patients with hyperthyroidism, what can be done?

A

Surgery

77
Q

What are some complications of thyroidectomy?

A

Hypothyroidism

Hypoparathyroidism

Damage to recurrent laryngeal nerves (revise)

Endocrine Week 3 2017/18 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions