Endocrine Thyroid

Question 1

Indications for Total thyroidectomy

Answer 1

Toxic Multinodular goiter
Thyroid carcinoma

Question 2

reduce uptake on isotope scan

Answer 2

Graves

Question 3

Rx solitary toxic node, family complete

Answer 3

Radioiodine

Question 4

AIT type 1
Sx & rx

Answer 4

Goitre
Carbimazole or potassium perchlorate

Question 5

AIT type 2
Sx & rx

Answer 5

No goiter
Corticosteroids

Question 6

Raised total T3 and T4 but normal fT3 and fT4

Answer 6

high conc. thyroid binding globulin,
seen during pregnancy

Question 7

RX thyroid storm

Answer 7

1. beta blockers,
2. propylthiouracil (stops the release and production of thyroid hormones and reduces the peripheral conversion of T4 to T3.)
3. Hydrocortisone (prevent the peripheral conversion of T4 to T3 )

Question 8

Toxic multinodular goitre
Nuclear scintigraphy
RX

Answer 8

Patchy uptake
Radioiodine therapy

Question 9

SIADH - drug causes

Answer 9

carbamazepine, sulfonylureas, SSRIs, tricyclics

Question 10

Function of T3 on somatic cells

Answer 10

increase Basel metabolic rate
Increase CO
Bone reabsorption
Activates sympathetic nervous sys.

Question 11

Why do you get oedema in Hypothyroidism

Answer 11

Increase in Gylcosaminoglycans = water retention

Question 12

Labs in Hypothyroid

Answer 12

low T4,T3 (thyroid glan not working)
TSH (stimulation of gland)-
Gland not working= high
pituitary gland not working= Low, Normal

Question 13

Subacute thyroiditis /deQuervain’s thyroiditis; Granulomatous giant cell thyroiditis.

Answer 13

Follows infection
tender thyroid
High esr
Progress from hyperthyroid to hypothyroid

Question 14

How long can postpartum hypothyroidism last

Answer 14

1 year

Question 15

Secondary Hypothyroidism

Answer 15

= reduce TSH production by pituitary gland

Question 16

Tertiary
Hypothyroidism

Answer 16

= reduce TRH damage to hypothalamus

Question 17

Subclinical hypothyroidism

Answer 17

Low/HIGH TSH, normal T4,T3

Question 18

What the difference btwn primary and secondary hypothyroid

Answer 18

Increase T3 &T4
primary - damage to the T gland =
secondary = Brain problems increased TSH

Question 19

Causes of Hashimoto

Answer 19

Question 20

TSH low T4&T3 HIGH

Answer 20

Primary hyperthyroidism
Ix radioactive uptake scan and Thyroid scan

Question 21

radioactive uptake scan Diffuse uptake

Answer 21

Grave

Question 22

radioactive uptake scan patchie up take

Answer 22

Toxicmultinodular goiter

Question 23

radioactive uptake scan decreased uptake

Answer 23

thyroiditis

Question 24

Raised TSH, T4,T3

Answer 24

Secondary Hyperthy

Question 25

rx toxic multinodular goitre

Answer 25

Surgery +
radioactive iodine (RI) (Not in child bearing wmn)
While waiting carbimazole

Question 26

RX graves w/ out eye disease or child bearing wmn

Answer 26

Radioactive iodine

Question 27

Anti-TSH receptor antibodies is associated with?

Answer 27

Graves 90% of pts

Question 28

Antibodies ass w/ graves (2)

Answer 28

Anti-TSH receptor antibodies = 90%
Anti-thyroid peroxidase (TPO) antibodies 75%

Question 29

discribe block and replace

Answer 29

arbimazole is started at 40mg
thyroxine is added when the patient is euthyroid
treatment typically lasts for 6-9 months