Endo 6 - thyroid disorders

Question 1

What is congenital hypothyroidism called? why does it cause this?

Answer 1

Cretinism

Thyroxine is essential for brain development. Iodide deficiency so no T4

Question 2

What is the name of the dimple at the back of the tongue and what caused the formation of that structure?

Answer 2

Foramen Caecum

This is a remnant left by the descending thyroglossal duct

Question 3

How are newborns tested for cretinism and what is the treatment?

Answer 3

Heel-prick test

TSH is measured and if it is ABNORMALLY HIGH then they are given THYROXINE

Question 4

Is thyroid disease more common in males or females?

Answer 4

Females
Female: Male ratio = 4:1
Affects 5% population

Question 5

Define myxoedema.

Answer 5

Primary Hypothyroidism - primary thyroid failure

Question 6

What is the most common cause of primary thyroid failure?

Answer 6

Autoimmune damage to the thyroid

Then it’s operation

Question 7

How do TSH levels change in primary thyroid failure?

Answer 7

TSH levels rise to try and stimulate and increase in thyroxine production
(eventually the TSH production will become exhausted and it will decline)
This is due to negative feedback - there is no thyroxine to negatively feedback the hypothalamus, so it secretes lots of TRH, and the pituitary so it secretes lots of TSH

Question 8

State some features of primary hypothyroidism.

Answer 8

EVERYTHING SLOWS DOWN - BMR
Deepening voice
Depression and tiredness
Bradycardia
Cold intolerance 
Weight gain and reduced appetite 
Constipation 
Eventually myxoedema coma

Treatment is essential

• -> will eventually die
• -> will perform poorly
• -> cholesterol levels go up and induce death

Question 9

What is the treatment for hypothyroidism?

Answer 9

Give THYROXINE (T4) daily and monitor TSH

Question 10

What is another word for hyperthyroidism?

Answer 10

Thyrotoxicosis

Question 11

How does TSH change in hyperthyroidism?

Answer 11

TSH is low because the elevated Thyroxine exerts a powerful negative feedback effect on hypothalamus and pituitary therefore no TSH

Question 12

State some features of hyperthyroidism

Answer 12

EVERYTHING SPEEDS UP
Myopathy
Mood swings
Hot intolerance
Raised BMR, HR, temperature
Loose weight
Diarrhea
Tremor
Increased appetite with loss of weight 
Palpitations
Sore eyes (Grave's)
Big goitre
Oligomenorrhea or amenorrhea
Nervoussness, excitability, insomnia, restlessness

Question 13

What is a common cause of hyperthyroidism?

Answer 13

Grave’s disease
->Autoimmune disease
the whole gland is enlarged and overractive
Antibody binds and stimulate TSH receptors so the whole gland is hyperactive
Sore eyes because antibodies attack the eyes - exophtalmos
Other antibodies stimulate growth of the shins and causes pretibial myxoedema (hypertrophy) -> non-pitting swelling - growth of soft tissue