Dysfunton Of The Thyroid Gland Flashcards
What is the shape of the thyroid gland
Butterfly shape
2 lobes
Would be connected by the isthmus
What happens in hypothyroidism
High levels of TSH
Low levels of t4 and t3
Why would the levels of TSH be high in hypothyroidism
The Brain would see that the thyroid gland would not working
Would then try to increase the levels of TSH to produce more thyroxine
How would you examine the thyroid gland
Observe
Examine from front (rotate and palpate)
Examine from the back
Measure the size of the lobes
What allows the thyroid gland to move upwards
Pre-tracheal fascia
Attaching the thyroid gland to the trachea and the larynx
What is radionuclide imaging
Shows the structure and morphology.
Use radioiodine (123 or 131)
Or 99m Tc technetium pertechneate
What are the other tests that can be used for the thyroid gland
CT
PET
MRI
fine needle aspiration biopsy
What does the CT and MRI show
Identifys the metastatic disease outside the neck
What does the fine needle aspiration biopsy do
Differentiates benign and the malignant thyroid nodules and the diffuse goitres
What does the PET scan show
Localise metastasic disease in TREATED thyroid cancer patients
What blood tests would you want to do
Levels of the TSH
Levels of the T3 and T4
What is a thyroid goitre
Enlargement of the thyroid gland
Normally through the Iodine deficiency or the multi-nodular goitre
(The increased levels of the TSH due to the decreased T4/T3that would lead to the enlargement)
What are the causes of the hypothyroidism
Hashimotos disease
TSH or TRH Deficiency
Post surgical
Radioactive iodine
What are the symptoms of hypothyroidism
Bradycardia
Weight gain
Muscle weakness and cramps
Excessive tiredness
Slow speech
Puffy eyes and face
Coarse facial features and the coarse hair
Swelling edema (especially around the eyes)
What is hashimotos disease
The autoimmune disease
Would have the antibodies against the thyroglobulin and the thyroid peroxidase
Could also be through the inflammation
How would you treat hypothyroidism
Give hormonal supplementation with the oral thyroxine
Thyroxine would no be broken down by the gastric acid
Give 30 mins before breakfast and any caffeine
What are the causes of hyperthyroidism
Graves’ disease (autoimmune)
Toxic mutinodular goitre
Solitary toxic adenoma
Excessive T4/T3 therapy
Drugs (amiodarone - k+ channel blocker)
What is Graves’ disease
When would have the TSI (thyroid stimulating immunoglobulin) that would bind to the TSH
This stimulates thyroid hormone secretion
What are the symptoms of the hyperthyroidism
Tachycardia
Lidlag
Increased sweating
Shaking
Tiredness and weakness
Staring eyes
What causes the lid lag and the staring eyes
Muscle LEVATOR PALPPEBRAE SUPERIORIS) contains smooth and skeletal muscle
Over stimulation of the sympathetic nervous system
So would have delayed relaxation of the smooth muscle
What other things does Graves’ disease cause
Buldging eyes (Exophthalmos)
Pre-tibial myxedema (plaque and yellowing of the lower limb)
What is a solidary toxic daemons
Adenoma (tumour) on the thyroid gland
Increased production of the thyroxine hormones
Can see through the radioactive iodine scan (no uniform distribution)
How would you treat hyperthyroidism
Carbimazole
(TPO cannot couple and add iodine to the tyrosine residues on the thyroglobulin)
What is primary hypothyroidism
Issue with the thyroid gland
High TSH
Low T4 and T3
