Hyper/Hypothyroidism

Question 1

which thyroid hormones are measured?

Answer 1

TSH
T4
T3

Question 2

which are the free thyroid hormones?

Answer 2

T4

T3

Question 3

hypothyroidism

Answer 3

results from a variety of abnormalities that cause insufficient secretion of thyroid hormones

Question 4

myxoedema coma

Answer 4

severe hypothyroidism

Question 5

pretibial myxoedema

Answer 5

accumulation of hydrophilic mucopolysaccharides in the ground substance of the dermis & other tissues causing doughy induration of the skin usually in the shins

Question 6

what disease is pretibial myxoedema usually seen in?

Answer 6

Graves disease (thyrotoxicosis)

Question 7

hashimoto’s thyroiditis

Answer 7

autoimmune hypothyroidism

Question 8

what are the causes of goitrous primary hypothyroidism?

Answer 8

chronic thyroiditis 
iodine deficiency (drug induced)

Question 9

what are the causes of non-goitrous hypothyroidism?

Answer 9

• congenital developmental defect
• atrophic thyroiditis
• post-ablative (radioiodine, surgery)
• postradiation (eg for lymphoma)

Question 10

what are the secondary causes of hypothyroidism?

Answer 10

hypothalamic

pituitary

Question 11

what can cause hypothalamic secondary hypothyroidism?

Answer 11

• congenital
• infection: encephalitis
• infiltration: sarcoidois
• malignancy eg craniopharyngioma

Question 12

what can cause pituitary secondary hypothyroidism?

Answer 12

panhypopituitarism

isolated TSH deficiency

Question 13

what can cause panhypopituitarism?

Answer 13

trauma
infection
infiltration
neoplasm

Question 14

what is hashimoto’s thyroiditis?

Answer 14

AI hypothyroidism

- autoimmune destruction of thyroid gland resulting in reduced thyroid hormone production

Question 15

in which sex is hashimoto’s thyroiditis more common in?

Answer 15

females

Question 16

what is hashimoto’s thyroiditis characterised by?

Answer 16

Presence of Thyroid Peroxidase Antibodies (in blood)

T-cell infiltrate and inflammation on microscopy

Question 17

what would you expect TSH to be in hypothyroidism?

Answer 17

high

Question 18

what would you expect T3 & T4 to be in hypothyroidism?

Answer 18

low

Question 19

what would you expect cholesterol to be in hypothyroidism?

Answer 19

high

Question 20

how should metabolic rate be restored?

Answer 20

gradually

Question 21

what could rapid restoration of metabolic rate cause?

Answer 21

cardiac arrhythmias

Question 22

what is the main treatment of hypothyroidism?

Answer 22

thyroxine (T4)

Question 23

what is the main treatment of hyperthyroidism?

Answer 23

carbimazole

propylthiouracil