endocrinology Flashcards
Describe features of goitre in hashimotos disease
Firm, non tender goitre.
Which autoantibodies are present in hashimoto’s?
Anti TPO (thyroid peroxidase) and anti thyroglobulin (anti tg)
Name 4 drugs that can cause hypothyroidism
Lithium. Carbimazole. Amiodarone (can also cause hyper). Iron (reduced absorption of thyroxine)
In what patient groups should you commence a lower dose of levothyroxine
Elderly/ cardiac disease.
How should people with pre-existing hypothyroidism be managed in pregnancy
Increase dose of levo 25-50micrograms as increased metabolic demands of the body
Treatment goal of levo?
Normal TSH
What eye signs are specific to graves disease
Exopthalmus and ophtlamoplegia
Specific signs of graves found on clinical exam?
1) Pretibial myoxedema.
2) Thyroid eye disease specifically exopthalmus and opthalmoplegia which can be sight threatening.
3) Thyroid acropachy: new bone formation, clubbing and soft tissue swelling.
What autoantibodies are found in graves disease
Anti TPO and TSH reception stimulating antibodies
Side effects to be aware of for carbimazole
Leukopenia, rash, agranulocytosis, vasculitis, arthralgia, fevers
When is radioiodine treatment contra-indicated
Pregnancy
Describe stages of de quervains/ subacute thyroiditis
1)3-6 weeks hyperthroidism with high esr and tender goitre.
2) 3 weeks euthyroid
3) weeks- months hypothyroidism.
4) resolution.
What often precedes subacute thyroiditis
Viral illness
Describe appearance schintigraphy of toxic multinodular goitre
Patchy update as many goitres on thyroid
What is sick euthyroid syndrome
Systemic illness causes all TFTs to be low. No problem with thyroid itself. Will resolve upon treatment of systemic illness.
