Clinical Thyroid Disease Flashcards
What are the key symptoms of hypothyroidism?
Weight gain, lethargy, feeling cold, constipation, heavy periods, dru skin and hair, bradycardia, slow reflexes, goitre, puffy face, large tongue, hoarseness and coma
What are the key symptoms of hyperthyroidism?
Weight loss, anxiety/irritability, heat intolerance, bowel frequency, light periods, sweaty palms, palpitations, hyperreflexia, goitre, thyroid eye problems
What are TSH and FT4 levels like in primary hyperthyroidism ?
LOW TSH, HIGH FT4 ;FT3
What are the TSH and FT4/FT3 levels in subclinical Hyperthyroidism?
LOW TSH, Normal FT4/FT3
How are the TSH levels and FT4 levels in secondary hypothyroidism?
Low TSH, Low FT4/FT3
What are the causes of secondary/tertiary hypothyroidism?
Pituitary tumour, craniopharyngioma, post pituitary surgery, radiotherapy, Sheehan’s syndrome, isolated TRH deficiency
What are the investigations of hypothyroidism?
TSH/fT4, AUTOANTIBODIES
FBC - MCV raised Lipids - hypercholesterolaemia Hyponatremia Increased muscle enzymes - ALT, CK Hyperprolactinaemia
How is hypothyroidism treated?
Levothyroxine
When should treatment for subclinical hypothyroidism be considered?
When TSH>10, When TSH>5 with +ve thyroid antibodies, TSH elevated with symptoms
How should you treat hypothyroidism during pregnancy?
Increased levothyroxine
What are the physiological causes of a Goitre?
Puberty, pregnancy
What are the autoimmune causes of a Goitre?
Graves disease, hashimotos disease
What else can case a goitre?
Thyroiditis, Iodine Deficiency, Dyshormogenesis and Goitrogens
What are the types of Goitre?
Multinodular goitre, diffuse goitre, cysts, tumours, miscellaneous (Sarcoidosis, Tb)
What are the investigations for a solitary goitre?
TFT, US, FNA, Isotope scanning
