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Endocrine > Hyper/hypothyroidism > Flashcards

Hyper/hypothyroidism Flashcards

1
Q

What are the levels of TSH and T3/4 in primary hyperthyroidism?

A

high T4/T3; low TSH

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2
Q

What are the levels of TSH and T3/4 in primary hypo?

A

high TSH and low T4/T3

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3
Q

What are the levels of TSH and T3/4 in seconandary hypo?

A

low TSH and low T3/4

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4
Q

What does myxoedema refer to?

A

severe hypothyroidism or pretibial myoxoesem

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5
Q

What is pretibial myxoedema?

A

a rash seen on the shins due to the accumulation of hydrophilic mucopolysaccharides in the ground substance of the dermis

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6
Q

What condition is pretibial myxoedema associated with?

A

Grave’s disease

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7
Q

What are the goitrous causes of primary hypothyroidism?

A

Hashimoto’s thyroiditis; iodine deficiency; drug induced

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8
Q

What drugs can cause hypothyroidism?

A

amiodarone; lithium

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9
Q

What can cause non-goitrous hypothyroidism?

A

atrophic thyroiditis; post-ablative; postradiation

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10
Q

What happens in Hashimoto’s thyroiditis

A

autoimmune destruction of thyroid gland resulting in reduced thyroid hormone production

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11
Q

What antibodies are foudn in the blood with Hashimoto’s?

A

thyroid peroxidase antibodies

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12
Q

What is seen on microscopy with Hashimotos?

A

Tcell infiltrate and inflammation

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13
Q

How does hypothyroidism affect the hair and skin?

A

coarse/sparse hair; dull expressionless face; periorbital puffiness; pale cool skin that feels doughy; vitiligo may be present (other AI disease)

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14
Q

What are the other signs of hypothyroidism?

A

cold intolernace; pitting oedema; reduced HR; caridac dilatation; periocardial effucion; hyperlipidaemia; weight gain; decreased appetite; constipation; deep hoarse voice; sleep apnea; muscle stiffnesscramps; carpal tunnel syndrome

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15
Q

What is seen on bloods with hypothyroidism?

A

macrocytosis; increased CK; LDL; hyponatraemia; hyperprolactinaemia

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16
Q

What antibodies are seen with Grave’s?

A

anti-TPO; anti-thryoglobulin; TSH receptor antibody

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17
Q

What antibodies are seen with autoimmune hypothyroidism?

A

anti-TPO and anti-thyroglobulin

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18
Q

Why should normal metabolic rate be restored gradually in hypothyroidism?

A

rapid restoration can precipitate cardiac arrhythmias

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19
Q

What is the treatment for hypothyroidism?

A

thyroxine (T4)

20
Q

What is used to measure therapeutic success in primary hypothyroidism?

A

TSH

21
Q

Who does myxoedema coma usually affect?

A

elderly women with long standing but unrecognised or untreated hypothyroidism

22
Q

What is seen with myxoedema coma?

A

bradycardia; heart block; type 2 resp failure

23
Q

What is seen in the eyes with hyperthyroidism?

A

lid retraction; double vision; eyes that protrude

24
Q

Who gets graves disease?

A

20-50 year olds; females; high iodine intake; smoking; ?viral trigger

25
Q

What is seen on scintigraphy or US with graves?

A

smooth symmetrical goitre

26
Q

What is the prognosis of graves?

A

by 18 months 50% will have burnt out and 50% will relapse

27
Q

What are the opthalmic features in graves?

A

lid retraction; lid lag; chemosis; proptosis; visual loss; diplopia

28
Q

Who gets nodular thyroid disease?

A

older patients

29
Q

What is seen on scintigraphy or US with nodular thyroid disease?

A

assymetrical goitre

30
Q

What is a thyroid storm?

A

severe hyperthyroidism- medical emergency

31
Q

What happens in a thyroid storm?

A

respiratory and cardiac collapse; exaggerated reflexes; hyperthermia

32
Q

What is the treatment for a thyroid storm?

A

glucocorticoids; propylthiouracil; beta-blcokers; fluids

33
Q

What causes the eye disease in graves?

A

mucles at the back of the eye are attacked by antibodies so become inflamed and swollen

34
Q

What are the drugs for hyperthyroidism?

A

carbimazole; propylthiouracil

35
Q

Which drug for hyperthyroidism is preferred in pregnancy?

A

propylthiouracil

36
Q

What is a risk in treatment of graves?

A

agranulocytosis

37
Q

What is used for symptomatic treatment of hyperthyroidism?

A

beta-blockers: propanolol

38
Q

What are the precautions taken with radio-iodine treatmetn for hyperthyroidism?

A

avoid prolonged contact with young hildren/pregnant women; dont share a bed for x days; avoid pregnancy for 6 months; ensure not pregnany

39
Q

What is subacute thyroiditis/de Quervains associated with?

A

sore throat/fever over viral symptoms

40
Q

Who gets de Quervains?

A

females; age 20-50

41
Q

What is seen on scintigraphy scan?

A

low uptake

42
Q

Approximately how many patients on amiodarone have abnormalities in thyroid function?

A

50%

43
Q

Where does amiodarone induced hypothyroidism occur?

A

areas with high iodine intake

44
Q

What are the levels of TSH and T3/4 in subclinical hyperthyroidism?

A

low TSH; normal T3/4

45
Q

What are the levels of TSH and T3/4 in subclinical hypothyroidism?

A

high TSH; normal T3/4

Endocrine (27 decks)

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