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Endocrinology > Hyperthyroidism > Flashcards

Hyperthyroidism Flashcards

1
Q

another word for hyperthyroidism?

A

Thyrotoxicosis

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2
Q

Define thyrotoxicosis?

A

overactive thyroid gland

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3
Q

most common cause

A

Grave’s disease

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4
Q

is Grave’s a primary or secondary problem?

A

primary

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5
Q

90% of grave’s will have what autoantibody?

A

TSH receptor antibodies

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6
Q

which gender effected most by hyperthyroidism?

A

females

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7
Q

When only T3 increased what is it called?

A

toxicosis

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8
Q

really high thyroid hormone causes what emergency?

A

Thyroid Storm

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9
Q

explain pathophys of grave’s?

A

Anti-TSH antibodies stimulate TSH receptor on thyroid gland > ↑thyroid hormone

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10
Q

how does grave’s cause a goitre?

step by step

A

Anti-TSH antibodies > hit TSH receptor on thyroid glands > iodine influx into thyroid gland > thyroid cell hyperplasia > goitre made

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11
Q

↑thyroid hormone will do what to meatbolism and SNS?

A

↑

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12
Q

how can pituitary adenoma cause a goitre?

A

↑TSH > iodine influx into thyroid gland > thyroid cell hyperplasia > goitre made

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13
Q

hyperthyroidism:

what happens to weight?

A

Lose weight

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14
Q

hyperthyroidism:

what happens to mood?

A

Anxiety

Irritability

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15
Q

hyperthyroidism:

main symptom at skin?

A

Sweaty

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16
Q

hyperthyroidism:

main gut symptom?

A

Diarrhoea

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17
Q

hyperthyroidism:

heart symptoms?
-2

A

Palpitations

Arrhythmias AF

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18
Q

hyperthyroidism:

symptom only women can get?

A

Oligomenorrhea

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19
Q

define oligomenorrhea?

A

very few or light periods

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20
Q

oligos meaning?

A

small

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21
Q

hyperthyroidism symptoms?

-9

A 
Sweaty 
Lose weight
Diarrhoea
Irritability 
Anxiety 
Tremor 
Palpitations 
Arrhythmias AF
Oligomenorrhea
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22
Q

grave’ specific symptoms at the face?

-2

A

Eyes – exophthalmos, ophthalmoplegia

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23
Q

eye symptoms when you have grave’s disease is called what?

A

thyroid eye disease

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24
Q

why you get thyroid eye disease in grave’s disease?

A

• Anti-TSH antibodies react with orbital antigen > thyroid eye disease

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25
Q

grave’ specific symptoms,
what triad of symptoms can you get?

what is this triad called?

A

clubbing, swollen hands and feet, new bone being made

Thyroid acropachy

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26
Q

graves’ dermopathy is aka what?

A

Pretibial myxedema

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27
Q

how does Pretibial myxedema look like on a pt?

A

swollen lower legs

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28
Q

Pituitary Adenoma can cause headaches.

why?

A

Pituitary adenoma stretches dura mater

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29
Q

Pituitary Adenoma can cause what visual field defect?

A

Bitemporal hemianopia

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30
Q

hyperthyroidism sign on neuro exam?

A

Hyperreflexia

31
Q

hyperthyroidism of the eyes?

A

Lid Lag

32
Q

pt has hyperthyroidism

1° thyroid problem will have what TFTs?

A

↑T4 ↑T3 ↓TSH

33
Q

pt has hyperthyroidism

1° thyroid problem will have what TFTs?

A

↑T4 ↑T3 ↓TSH

34
Q

pt has hyperthyroidism

2° thyroid problem will have what TFTs?

A

↑T4 ↑T3 ↑TSH =

35
Q

↑T3 only is called what?

A

toxicosis

36
Q

% wise how many hyperthyroidism are primary vs secondary?

A

99% are primary

37
Q

define 1° thyroid problem?

A

problem at thryoid gland itself?

38
Q

1° hyperthyroid problem.

TSH levels?

A

↓TSH

39
Q

1° hyperthyroid problem.

T4 and T3 levels?

A

↑T4 ↑T3

40
Q

2° hyperthyroid problem.

TSH levels?

A

↑TSH

41
Q

in 1° hyperthyroid problem why is TSH low?

A

negative feedback

42
Q

you do blood test for antibodies in pt with Graves.

main antibody in graves?

A

TSH receptor antibodies

43
Q

you do blood test for antibodies in pt with Graves.

2nd most common antibody in graves?

how many will have this antibody?

A

Anti-thyroid peroxidase antibodies

70%

44
Q

you do blood test for antibodies in pt with Graves.

3rd most common antibody in graves?

how many will have this antibody?

A

Anti-thyroglobulin

30%

45
Q

Ix to look at iodine uptake in thyroid gland?

(what is it called?

A

Thyroid scintigraphy

46
Q

Thyroid scintigraphy result in Grave’s?

A

diffuse uptake of I-

47
Q

Ix to check for goitre compression?

A

CT/MRI

48
Q

best Ix to check for thyroid cancer?

A

fine-needle biopsy

49
Q

bets Ix to check for Pituitary adenoma problem in suspected secondary hyperthyroidism?

A

MRI brain

50
Q

glucose levels in hyperthyroidism?

up or down

A

up

51
Q

pt has hyperthyroidism.

why would you do ECG?

what are you looking for?

A

ECG

AF

52
Q

pt has hyperthyroidism.

has mild symptoms,
drug given to stop tremor?

A

propranolol

53
Q

pt has hyperthyroidism.

cause is Grave’s disease

main drug given?
-name

A

carbimazole

54
Q

pt has Grave’s disease.

mainstay drug given?
-name

strength?

A

carbimazole

40mg

55
Q

pt has Grave’s disease.

carbimazole not worked.

2nd line treatment?

A

radioiodine treatment

56
Q

pt has Grave’s disease

radioiodine treatment not worked, still has symptoms.

3rd line treatment?

A

thyroidectomy

57
Q

women is pregnant, has grave’s disease.

mainstay drugs given?
-2 (names)

A

Propylthiouracil in 1st trimester then switch to carbimazole

58
Q

pt has Thyroid eye disease.

what do you give to treat these symptoms 1st line?
-group

A

topical lubricants

59
Q

pt has Thyroid eye disease.

topical lubricants used, still has symptoms.

2nd line Mx?

  • 2
  • one is drug class
A

steroids or orbital radiation

60
Q

pt has hyperthyroidism,
cause is thyroiditis.

1st Line Mx?

A

do nothing,

self-limiting ∴ treatment rarely needed

61
Q

pt has hypothyroidism,
cause is pituitary adenoma.

main treatment?

A

radioiodine therapy

62
Q

pt has hyperthyroidism,
cause is Goitre .

main treatment?

A

radioiodine therapy

63
Q

outline 3 step Mx plan for Grave’s disease?

A
  1. Start carbimazole at 40 mg
  2. Reduce dose gradually to maintain euthyroidism
  3. Continue for 12-18 months
64
Q

how many will relapse after the 3step Mx plan?

-% wise

A

50%

65
Q

Carbimazole moa?

A

blocks thyroid peroxidase

66
Q

blocking thyroid peroxidase does what exactly?

A

blocks iodination of thyroglobulin

67
Q

Carbimazole main dangerous se?

A

agranulocytosis

68
Q

Propylthiouracil moa?

A

blocks iodination of thyroglobulin

69
Q

radioactive iodine is abbreviated to what?

A

I-131

70
Q

Radioactive iodine therapy is contraindicated in what thyroid disease?

why?

A

thyroid eye disease

can make it worse

71
Q

Thyroidectomy.

2 main risks?

A

risk of hypothyroidism

risk of recurrent laryngeal nerve palsy

72
Q

Radioactive iodine therapy has what ironic long term complication?

what drug do you give to treat this?

A

hypothyroidism

levothyroxine

73
Q

female is going to have radioactive iodine therapy.

what pt advice do you give her?

A

do not become pregnant for 6 months

74
Q

how does I-131 help hyperthyroidism?

A

sticks to thyroid cancer cells or just thyroid cells,

then radiation will kill these cells

Endocrinology (16 decks)

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