Endocrine Flashcards
1
Q
Block and replace?
A
Carbimazole started at 40mg
Thyroxine added when euthyroid
Tx for 6-9 months
2
Q
Radioiodine treatment contraindications and side effects?
A
Contraindications
- Pregnancy (avoid 4-6 months after)
- Age <16
- Thyroid eye disease (relative - can worsen it)
Side effects
- Hypothyroid
3
Q
Management of thyroid storm?
A
- Symptomatic treatment e.g. Paracetamol
- Treatment of underlying precipitating event
- Anti-thyroid drugs: e.g. Methimazole or propylthiouracil
- Lugol’s iodine
- Dexamethasone - e.g. 4mg IV QDS - blocks the conversion of T4 to T3
- Propranolol
4
Q
Subacute thyoriditis (De Quervain’s)?
A
Tender goitre, hyperthyroid, raised ESR
Globally reduced uptake on technetium thyroid scan
5
Q
Hashimoto’s thyroiditis?
A
Autoimmune
Hypothyroidism (sometimes transient thyrotoxicosis in acute phase)
Antiboides
- Anti-thyroid peroxidase (Anti TPO)
- Microsomal antiboides
- Anti-Tg
6
Q
Subclinical hyperthyroidism?
A
Definition
- Normal T3-T4
- Low TSH (<0.1)
- Potential effect on CVS (AF) and bone metabolism (osteoporosis), increased likelihood of dementia
Causes
- Multinodular goitre
- Excessive thyroxine
Management
- TSH levels sometimes revert back to normal
- Therapeutic trial of low dose antithyroid agent (6 months –> attempt to induce remission)
7
Q
Subclinical hypothyroidism?
A
Definition
- Normal T3-T4
- Rasied TSH
- No obvious symptoms
Risk of progression to hypothyroidism (2-5%)
Treat if
- TSH >10
- Thyroid antibodies +ve
- Other autoimmune disorder
- Previous graves disease treatment
8
Q
Causes of hypothyroid?
A
- Primary Hypothyroidism
- Primary atrophic hypothyroidism
- Hashimoto’s thyroiditis
- Post-thyroidectomy
- Drug therapy (lithium, amiodarone, carbimazole)
- Dietary iodine deficiency
- Seondary Hypothyroidism
- Pituitary failure
- Down’s, Turner’s, Coeliac
9
Q
A
10
Q
Side effects of thyroxine?
A
- Hyperthyroidism: due to over treatment
- Reduced bone mineral density
- Worsening of angina
- Atrial fibrillation
11
Q
TFTs summary?
A
12
Q
A
