259. Diseases of the thyroid Flashcards
In what conditions would thyroid function be screened for?
Patients with a fib Patients with hyperlipidaemia Diabetus mellitus Woman with type 1 dm during 1st trimester and post delivery Patients on amiodarane/lithium Patients with down's or turner's
If TSH and T4 were normal, but t3 was lowered, what would this tell you about there disease?
Slow conversion of T4 to T3 (deiodinase dediciency)
What tests can be used to investigate thyroid function?
TFT’s
Thyroid autoantibdies
Serum thyroglobulin
USS
Isotope scan- shows hot and cold areas of thyroid
What are the signs of hyperthyroidism?
Diarrhoea, decreased weight, increased apeitie, sweats, palpitations, tremors,
What are the signs of hyperthyroidsim?
Fast/irregular pulse
Warm, moist skin, fine tremor
thin hair
lid lag, lid retraction, proptosis, exopthalmos
What is the most common cause of hyperthyrodism?
Graves disease. Autoimmune disease that causes increased thyroid production
typically occurs in woman aged 40-60
Associated with type 1 dm, addison’s
What are some other causes of hyperthyroidism?
Toxic multinodular goitre-
Toxic adenoma- single nodule produces T3
Ectopic thyroid tissue
Exogenous- iodine excess
De quarvians thyroidtits- post viral
How can medications tackle hyperthyroid disease?
b blockers- rapid control of symptoms
Block- carbimazole
Block and treat - carbimazole and levothyroxin
What are the signs of thyroid eye disease
tear production
Photophobia
diplopia
decreased acuity
What are the differentials for goitre?
physilogical
Graves
Hashimotos
Subacute de quervains
Multinodular goitre
Adenoma
Carcinome
What are the differentials for goitre?
physilogical
Graves
Hashimotos
Subacute de quervains
Multinodular goitre
Adenoma
Carcinoma
What are the symptoms of hyopthyroidsim?
Tiredness, sleepy, lethargic, low mood, increased weight, constipation, menorrhagia, hoarse voice, decreased memory and cognition
What are the signs of hypothyroidism?
B- radycardia R- reflexes that are slow A- taxia D-ry thin hair Y- awning/drowsy C-old hands A- scites R-ound puffy face D- efeated demenour I- mmobile + ileus C- CF
What are the main causes of hypothyroidism?
How do you differentiate between them?
primary atrophic- Diffuse lymphocytic infiltration of the thyroid leading to atrophy, hence no goitre
Hashimoto’s- goitre due to lymphocytic and plasma cell infiltration
What is hypothyroidism associated with?
Type 1 DM, Addison’s, pernicious aneamia
Turner’s and Down’s, CF
