Clinical Thyroid Disease Flashcards
what are symptoms of hypothyroidism
Weight Gain Lethargy Feeling cold Constipation Heavy periods Dry Skin/Hair Bradycardia Slow reflexes
what are symptoms of hyperthyroidism
Weight Loss Anxiety/Irritability Heat Intolerance Bowel frequency Light periods Sweaty palms Palipitations Hyperreflexia/Tremors
what will be the levels of TSH in someone who is hyperthyroid
suppressed TSH
what are causes of hyperthyroidism (sometimes referred to as thyrotoxicosis)
Grave’s disease 70%
Toxic multinodular Goitre 20%
pituitary adenoma
what accounts for 80% of hyperthyroidism
Grave’s disease (autoimmune)
what can be detected in Grave’s disease to confirm the diagnosis
stimulatory TSH autoantibodies
what is multinodular goitre
where benign nodules develop with age and become hyperfunctioning
what is carbimazole
antithyroid drug (used to treat hyperthyroidism, inhibits TH production)
what is propylthiouracil
medication used to treat hyperthyroidism
what are possible side effects of hyperthyroid drugs
rash
agranulocytosis
radioiodine treatment can be given to treat hyperthyroidsim what is the risk of it
70 % risk of hypothyroidism
what is subclinical hyperthyroidism
TSH supressed
normal free thyroid hormones
what are causes of hypothyroidism
congenital
autoimmune (Hashimotos)
iatrogneic (postoperative)
iodine deficiency
in primary hypothyroidism what are TSH/T4/T3 levels
Raised TSH, Low T4 & T3
in subclinical hypothyroidism what are TSH/T4/T3 levels
Raised TSH: Normal T4 & T3
in secondary hypothyroidism what are TSH/T4/T3 levels
Low TSH, Low T4 & T3
secondary hypothyroidism effects what structure
the pituitary
what is the prevalance of hypothyroidism
Commonest endocrine condition after diabetes
what are the causes of secondary hypothyroidism
pituitary tumour
craniopharyngioma
what is the investigation of hypothyroidism
TSH / fT4
Autoantibodies: TPO (Thyroid peroxidase antibodies)
what is the treatment of hypothyroidism
levothyroxine (T4) tablets
what are the causes of goitre
puberty pregnancy
Grave’s
hashimotos
iodine deficiency
what are possible clinical signs of Grave’s diesase
goitre exophthalmos Grave's Dermopathy (shins) clubbing gynecomastia (males)
what is the most common cause of hyperthyroidism in the elderly
multi-nodular goitre
who gets subacute thyroiditis
younger patients <50
what triggers subacute thyroiditis
usually viral trigger
what should the investigation be of a solitary thyroid nodule
TFT’s
USS (malignancy)
FNA
what is the most common type of thyroid cancer
papillary
what is another type of thyroid cancer apart from papillary
follicular
what is the general management of thyroid cancer
near total thyroidectomy
high dose radioiodine
follow up with thyroglobulin
what cells does medullary thyroid cancer arise from
parafollicular C cells
what type of Multiple Endocrine Neoplasia is medullary thyroid cancer associated with
MEN type 2
