Endocrinology 6 - Hypothyroidism

Question 1

explain Hashimoto’s thyroiditis

Answer 1

most common cause in Western world
anti-TPO

autoimmune
start with goitre then atrophies

Question 2

iodine deficiency

Answer 2

can cause hypothyroid, much more likely in poorer countries

Question 3

2 medications that can trigger hypothyroid

Answer 3

aside from secondary overtreatment of hyperT

lithium and amiodarone

(amiodarone can also trigger thyrotox too)

Question 4

4 central causes of hypothyroid

Answer 4

vascular - bleed, Sheehan
infection
tumour
radiation

Question 5

7 features of hypothyroidism

Answer 5

weight gain
fatigue
dry skin
hair loss, dry hair
fluid retention! (oedema, pleural effusion, ascites)
amenorrhoea
constipated

Question 6

hormone levels in primary and secondary hypoT

Answer 6

primary - low T3,4, high TSH
secondary - low T3,4, low TSH
give levothyroxine (synthetic T4)

as started, measure TSH monthly until stable dose