Endocrine - Thyroid Disease Flashcards
what are the types of thyroid cancer?
papillary
follicular
anaplastic
MTC
what is MTC associated with?
MEN 2
features of thyroid cancer?
nodule
hoarseness
dysphagia
what is a risk factor for follicular thyroid cancer?
iodine deficiency
what type of thyroid cancer has associations with hashimoto’s?
papillary
Ix for thyroid cancer?
TFTs TPO (for hashimoto's) US FNA radioactive iodine scan (cold nodule) CT/MRI to stage
Tx for thyroid cancer?
surgery
+ levothyroxine
what causes primary and secondary hypothyroid?
primary: low T3 and 4
secondary: low TSH
features of hypothyroidism?
cold sensitivity constipated wt gain depression infertility menorrhagia hyperlipidaemia carpal tunnel
skin features of hypothyroid?
loss of lateral 1/3rd eyebrow
diffuse alopecia
dry skin
what are iatrogenic causes of hypothyroid?
radiotherapy
sarcoidosis
lithium
amiodarone (if iodine rich)
bloods for hypothyroid and results?
TSH high
T4 low
FBC (may be anaemic)
LDL (may be high)
tx for hypothyroid?
levothyroxine
what blood is used to monitor hypothyroid?
T4
extreme hypothyroidism can result in?
myxoedema coma (emergency)
features of grave’s disease?
wt loss diarrhoea amenorrhoea tremor palpitations sweating irritable
examination findings of hypothyroidism?
bradycardia
deep voice
delayed reflexes
non tender goitre
examination findings of hyperthyroidism?
goitre
pretibial myxedema
thyroid acropachy
what are features of thyroid eye disease?
exopthalmos lid retraction gritty eyes loss of colour vision diplopia
Ix and results for graves disease?
T4 (high)
TSH (low)
TRAb present
tx for graves disease?
carbimazole for 18months, bloods rechecked
PTU in pregnancy
propranolol/CCB for tremor
steroids for eye disease
radioiodine
surgery
risk of thyroid surgery?
recurrent laryngeal nerve damage
PTH damage
hypothyroid
rules for radioiodine?
no pregnancy for 6 months
stay away from kids/pregnant women fro 3 weeks
side effects of carbimazole?
agranylocytosis
autoimmune hepatitis
when does a thyroid storm often occur?
after infection/surgery
what is the Tx for a thyroid storm?
lugol's iodine glucocorticoid (beclamethasone, hydrocortisone etc..) PTU Bb fluids
what occurs in hashimoto’s?
transient phase of hyperthyroid then hypothyroid
risk factors for hashimoto’s?
excess iodine
postnatal
Li
autoimmune disease
Ix for hashimoto’s and results?
TSH (high)
T4 (low)
TPO antibodies
Tx for hashimoto’s?
monitor to see if resolves
levothyroxine
(Bb/CCB if during hyperthyroid phase)
what occurs in a multinodular goitre?
multiple nodules causing hyperthyroidism
Tx for a multinodular goitre?
radioiodine
surgery
propranolol/CCB for tremor
who gets de quervains? how does it present?
women after an URTI
hyperthyroid + sore thyroid
what is iodine uptake like on a scan of someone with de quervains?
reduced iodine uptake
what does medullary thyroid cancer secrete? what does this hormone do?
calcitonin
reduce Ca
blood results in sick euthyroid?
low TSH
low T3/4
