Dysfunton Of The Thyroid Gland

Question 1

What is the shape of the thyroid gland

Answer 1

Butterfly shape
2 lobes
Would be connected by the isthmus

Question 2

What happens in hypothyroidism

Answer 2

High levels of TSH
Low levels of t4 and t3

Question 3

Why would the levels of TSH be high in hypothyroidism

Answer 3

The Brain would see that the thyroid gland would not working
Would then try to increase the levels of TSH to produce more thyroxine

Question 4

How would you examine the thyroid gland

Answer 4

Observe
Examine from front (rotate and palpate)
Examine from the back
Measure the size of the lobes

Question 5

What allows the thyroid gland to move upwards

Answer 5

Pre-tracheal fascia
Attaching the thyroid gland to the trachea and the larynx

Question 6

What is radionuclide imaging

Answer 6

Shows the structure and morphology.
Use radioiodine (123 or 131)
Or 99m Tc technetium pertechneate

Question 7

What are the other tests that can be used for the thyroid gland

Answer 7

CT
PET
MRI
fine needle aspiration biopsy

Question 8

What does the CT and MRI show

Answer 8

Identifys the metastatic disease outside the neck

Question 9

What does the fine needle aspiration biopsy do

Answer 9

Differentiates benign and the malignant thyroid nodules and the diffuse goitres

Question 10

What does the PET scan show

Answer 10

Localise metastasic disease in TREATED thyroid cancer patients

Question 11

What blood tests would you want to do

Answer 11

Levels of the TSH
Levels of the T3 and T4

Question 12

What is a thyroid goitre

Answer 12

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)

Question 13

What are the causes of the hypothyroidism

Answer 13

Hashimotos disease
TSH or TRH Deficiency
Post surgical
Radioactive iodine

Question 14

What are the symptoms of hypothyroidism

Answer 14

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)

Question 15

What is hashimotos disease

Answer 15

The autoimmune disease
Would have the antibodies against the thyroglobulin and the thyroid peroxidase
Could also be through the inflammation

Question 16

How would you treat hypothyroidism

Answer 16

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

Question 17

What are the causes of hyperthyroidism

Answer 17

Graves’ disease (autoimmune)
Toxic mutinodular goitre
Solitary toxic adenoma
Excessive T4/T3 therapy
Drugs (amiodarone - k+ channel blocker)

Question 18

What is Graves’ disease

Answer 18

When would have the TSI (thyroid stimulating immunoglobulin) that would bind to the TSH
This stimulates thyroid hormone secretion

Question 19

What are the symptoms of the hyperthyroidism

Answer 19

Tachycardia
Lidlag
Increased sweating
Shaking
Tiredness and weakness
Staring eyes

Question 20

What causes the lid lag and the staring eyes

Answer 20

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

Question 21

What other things does Graves’ disease cause

Answer 21

Buldging eyes (Exophthalmos)
Pre-tibial myxedema (plaque and yellowing of the lower limb)

Question 22

What is a solidary toxic daemons

Answer 22

Adenoma (tumour) on the thyroid gland
Increased production of the thyroxine hormones
Can see through the radioactive iodine scan (no uniform distribution)

Question 23

How would you treat hyperthyroidism

Answer 23

Carbimazole
(TPO cannot couple and add iodine to the tyrosine residues on the thyroglobulin)

Question 24

What is primary hypothyroidism

Answer 24

Issue with the thyroid gland
High TSH
Low T4 and T3

Question 25

What is secondary hypothyroidism

Answer 25

Issue with the anterior pituitary gland
Low TSH
Low T4 and T3

Question 26

What happens to the levels in hyperthyroidism

Answer 26

Low TSH
High t4 and T3

Question 27

What do people with hypothyroidism normally present with on their neck

Answer 27

A small thyroid goitre due to inflammation