Hyper/hypothyroidism Flashcards
what is the most commonest form of thyroid disease
autoimmune
what 3 things do you use to measure thyroid hormone?
TSH, T3/4
in primary hyperthyroidism, is TSH high or low
low TSH, high T3/4
in primary hypothyroidism is TSH high or low, T3/4 high or low
TSH high, T3/4 low
In secondary hyperthyroidism, what are the TSH and T3/4 levels
High for both
In secondary hypothyroidism is TSH and T3/4 high or low
low
what does myxoedema coma refer to?
severe hypothyroidism
what are 2 common cause of primary hypothyroidism
hashimotos thyroiditis and iodine deficiency
what are non goitrous causes of hypothyroidism?
radioiodine, atrophic thyroiditis
what biochemistry markers are noted in hashimotos thyroidits
thyroid peroxidase antibodies in blood, T cell infiltrate and inflammation
what are some signs and symptoms of hypothyroidism
dull expression, pale skin, vitiligo, cold intolerance and pitting oedema, decreased appetite and weight gain
what would lab results show for hypothyroidism
High TSh, Low T3/4, increased CK, increased LDL,
how do you manage hypothyroidism
young: thyroxine 50-100micrograms, elderly: 25-50 micrograms. Check TSH 2 months after dose change
Should you increase thyroxine dose during pregnancy?
of course
what would you find in patients with myxoedema coma
bradycardia, Type 2 resp failure, adrenal failure
how dos uo treat myxoedema coma
ABC- rewarm, antibiotics, control BP, fluids,
what drug can cause thyroid dysfunction
amiodarone
what are sings of hyperthyroidism
palpitations/ Afib, cardiac failure, tremor, sweating, lid retraction, double vision, bulging eyes
what are some causes of hyperthyroidism
GRAVES, multi nodular goitre, thyroiditis
does graves disease happen young or old
young
do graves disease patients have a high iodine intake?
yea
what are ophthalmopathy features of hyperthyroidism
bulging eyes, lid retraction, lid lag, proptosis
who does multi nodular goitre affect?
older patients
is multi nodular goitre antibody positive or negative?
negative
is multinodualr goitre symmetrical or asymmetrical?
assymetrical
how do you treat hyperthyroidsim
carbimazole/ propylthiouracil
what could you add in treatment of hyperthyroidism>
beta blockers- fast acting
