endo - thyroid Flashcards
most common cause of congenital hypothyroidism in the UK
maldescent of the thyroid/athyrosis
- theres a mass at the back of the tongue or neck
most common cause of congenital hypothyroidism in consanguineous parents
dyshormonogenesis - inborn error of thyroxine synthesis
most common cause of congenital hypothyroidism in the world
iodine deficiency in diet
clinical features of congenital hypothyroidism
usually nothing - just found on screening
faltering growth feeding problems jaundice constipation pale, cold mottled skin large tongue hoarse cry umbilical hernia, goitre delayed developement
clinical features of acquired hypothyroidism
females more short cold intolerant dry skin, cold hands/feet bradycardia puffy eyes, loss of eyebrows goitre slow relaxing reflexes constipation delayed puberty/amenorrhoea obesity - slipped upper femoral epiphysis poor concentration (affects school) learning difficulties
treatment of hypothyroidism
thyroxine - lifelong
most common cause of acquired hypothyroidism?
autoimmune thyroiditis
hyperthyroidism - most common cause
Grave’s disease - autoimmune thyroiditis from thyroid stimulating immunoglobulins
hyperthyroidism - biochemistry
high thyroxine (t4) and or t3
TSH low
anti-thyroid peroxisomal antibodies may be present and eventually cause hypothyroidism
hyperthyroidism treatment
what is it and what do they need to know
carbimazole or propylthiouracil
neutropenia risk - so sore throat and fever > go to hospital immediately
b blockers for anxiety, tremor, HR^ etc
usually treat for 2 years
hyperthyroid clinical features
anxiety, restless, tremor hungry sweaty, warm, vasodilated peripheries diarrhoea weight loss rapid growth in height tachycardia, wide pulse pressure goitre (and bruit) learning difficulties, behavioural issues, psychosis eye signs - exophthalmos, ophthalmoplegia, lid retraction, lid lag
what does parathyroid hormone do
increases calcium level in blood via
osteoclast stimulation (bone remodelling)
increasing renal reabsorption of calcium
activates vitamin D - absorb more ca in gut
hypoparathyroidism =
low calcium (muscle spasm, fits, stridor, diarrhoea, rickets)
often from congenital deficiency (ie DiGeorge)
pseudohypoparathyroidism
end organ resistance to PTH
so normal PTH levels but low calcium and high phosphate
treatment of hypocalcaemia
calcium gluconate (diluted 10%) if acute symptomatic
vitamin D and oral calcium if chronic
