Clinical Thyroid Disease

Question 1

what are symptoms of hypothyroidism

Answer 1

Weight Gain
Lethargy
Feeling cold
Constipation
Heavy periods
Dry Skin/Hair
Bradycardia
Slow reflexes

Question 2

what are symptoms of hyperthyroidism

Answer 2

Weight Loss
Anxiety/Irritability
Heat Intolerance
Bowel frequency
Light periods
Sweaty palms
Palipitations
Hyperreflexia/Tremors

Question 3

what will be the levels of TSH in someone who is hyperthyroid

Answer 3

suppressed TSH

Question 4

what are causes of hyperthyroidism (sometimes referred to as thyrotoxicosis)

Answer 4

Grave’s disease 70%

Toxic multinodular Goitre 20%

pituitary adenoma

Question 5

what accounts for 80% of hyperthyroidism

Answer 5

Grave’s disease (autoimmune)

Question 6

what can be detected in Grave’s disease to confirm the diagnosis

Answer 6

stimulatory TSH autoantibodies

Question 7

what is multinodular goitre

Answer 7

where benign nodules develop with age and become hyperfunctioning

Question 8

what is carbimazole

Answer 8

antithyroid drug (used to treat hyperthyroidism, inhibits TH production)

Question 9

what is propylthiouracil

Answer 9

medication used to treat hyperthyroidism

Question 10

what are possible side effects of hyperthyroid drugs

Answer 10

rash

agranulocytosis

Question 11

radioiodine treatment can be given to treat hyperthyroidsim what is the risk of it

Answer 11

70 % risk of hypothyroidism

Question 12

what is subclinical hyperthyroidism

Answer 12

TSH supressed

normal free thyroid hormones

Question 13

what are causes of hypothyroidism

Answer 13

congenital
autoimmune (Hashimotos)
iatrogneic (postoperative)
iodine deficiency

Question 14

in primary hypothyroidism what are TSH/T4/T3 levels

Answer 14

Raised TSH, Low T4 & T3

Question 15

in subclinical hypothyroidism what are TSH/T4/T3 levels

Answer 15

Raised TSH: Normal T4 & T3

Question 16

in secondary hypothyroidism what are TSH/T4/T3 levels

Answer 16

Low TSH, Low T4 & T3

Question 17

secondary hypothyroidism effects what structure

Answer 17

the pituitary

Question 18

what is the prevalance of hypothyroidism

Answer 18

Commonest endocrine condition after diabetes

Question 19

what are the causes of secondary hypothyroidism

Answer 19

pituitary tumour

craniopharyngioma

Question 20

what is the investigation of hypothyroidism

Answer 20

TSH / fT4

Autoantibodies: TPO (Thyroid peroxidase antibodies)

Question 21

what is the treatment of hypothyroidism

Answer 21

levothyroxine (T4) tablets

Question 22

what are the causes of goitre

Answer 22

puberty pregnancy
Grave’s
hashimotos
iodine deficiency

Question 23

what are possible clinical signs of Grave’s diesase

Answer 23

goitre
exophthalmos 
Grave's Dermopathy (shins)
clubbing
gynecomastia (males)

Question 24

what is the most common cause of hyperthyroidism in the elderly

Answer 24

multi-nodular goitre

Question 25

who gets subacute thyroiditis

Answer 25

younger patients <50

Question 26

what triggers subacute thyroiditis

Answer 26

usually viral trigger

Question 27

what should the investigation be of a solitary thyroid nodule

Answer 27

TFT’s
USS (malignancy)
FNA

Question 28

what is the most common type of thyroid cancer

Answer 28

papillary

Question 29

what is another type of thyroid cancer apart from papillary

Answer 29

follicular

Question 30

what is the general management of thyroid cancer

Answer 30

near total thyroidectomy

high dose radioiodine

follow up with thyroglobulin

Question 31

what cells does medullary thyroid cancer arise from

Answer 31

parafollicular C cells

Question 32

what type of Multiple Endocrine Neoplasia is medullary thyroid cancer associated with

Answer 32

MEN type 2