Clinical thyroid disease Flashcards
hypothyroid symptoms
weight gain
lethargy
feeling cold
constipation
heavy periods
dry skin/hair
bradycardia
slow reflexes
goitre
hyperthyroid symptoms
weight loss
anxiety
heata tolerance
bowel frequency
light periods
sweaty palms
paliptations
tremors
goitre
What is the most common endocrine condition?
after diabetes
hypothyroidism
acquired causes of primary hypothyroidism
autoimmune thyroid disease (hashimotos)
Iatrogenic
chronic iodine deficiency
post-subacute thyroiditis .
investigations of hypothyroidism
TSH/ fT4
autoantibodies (TPO) (thyroid peroxidase antibodies)
treatments for hypothyroidism
levothyroxine (T4) tablets
liothyronine (T3)
special situations for hypothyroidism treatment
ischaemic heart disease
pregnancy
postpartum thyroiditis
myxedema coma
……. levothyroxine required during pregnancy
increased
in pregnancy - Inadequately treated hypothyroidism linked with
increased foetal loss
lower IQ
physiological causes of goitre
puberty
pregnancy
autoimmune goitre causes
graves disease
hashimotos disease
goitre causes
graves
hashimotos
thyroiditis
iodine deficiency
dyshormogenesis
goitre types
multi-nodular
diffuse goitre (colloid and simple)
cysts
tumours
solitary thyroid nodule investigations
thyroid function test
ultrasound
fine needle aspiration
isotope scanning
two types of thyroid cancer
papillary
follicular
thyroid cancer management
near total tyroidectomy
high dose radioiodine
long term suppressive doses of thyroxine
two other types of thyroid cancer
anaplastic
lymphoma
medullary thyroid cancer tumours arise from
parafollicular C cells
treatment for medullary thyroid cancer is a
total thyroidectomy
causes of primary thyrotoxicosis
graves disease
toxic multi-nodular goitre
toxic adenoma
causes of secondary thyrotoxicosis
pituitary adenoma secreting TSH
what does Thyrotoxicosis mean?
excess of thyroid hormone in the body
Graves disease is what percentage of all cases of hyperthyroidism?
70-80%
Grave’s disease is an autoimmune condition driven by what two types of antibodies?
thyroid peroxidase antibodies
TSH receptor antibodies
What is the most common type of thyrotoxicosis in the eldery?
multi-nodular goitre
antithyroid drugs
carbimazole
propylthiouracil
levothyroxine starts at 50mcg/day and the dose gets increased until what is normal?
TSH levels
ATD (antithyroid drugs) are usually given as a ……. regime
titration
Treatment of thyroxicosis
radioiodine
anti-thyroid medication (carbimazole)
beta blockers (propranolol)
