25. Thyroid Disorders Flashcards
What is the most sensitive marker of thyroid status?
TSH
What is subclinical hypothyroidism?
Normal T4 but increased TSH
When should subclinical hypothyroidism be treated?
Pregnancy: increased risk miscarriage
if TSH >10
What is the treatment for hypothyroidism?
Levothyroxine
‘Start low go slow’
What is the aim of treatment in primary hypothyroidism?
Normalise TSH
What is the aim of treatment in secondary hypothyroidism?
Treat adrenal problem
Aim for normal T4 and ignore TSH
What is a thyroid scintigraphy?
Looks at the uptake of iodine in the thyroid
Diffuse uptake in graves, nodules have a more focal uptake
What are the treatment options for hyperthyroidism?
Thyroid hormone synthesis inhibitors
Thyroid hormone secretion blockade
B-blockers
Corticosteroids if severe
Name a thyroid hormone synthesis inhibitor
Carbimazole
What are the side effects of carbimazole?
Agranulocytosis
Pancytopaenia
Teratogenic: switch to propylthiouracil if pregnant and monitor LFTs
When should a patient stop taking carbimazole?
If they get a sore throat they should pause the drug and get an FBC as sore throat is the first sign of agranulocytosis
When is radioactive iodine therapy used?
Relapsed Grave’s disease
Patient can’t be around young children due to radiation risk
Contraindicated in Grave’s opthalmopathy
What are the complications of thyroidectomy?
Haemorrhage
Infection
Damage to the laryngeal nerve
Hypothyroidism, hypoparathyroidism
What is subclinical hyperthyroidism?
Persistant TSH
When and why should subclinical hyperthyroidism be treated?
Over 65s as carries the risk for atrial fib and osteoporosis
