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ENDO > Hyperthyroidism > Flashcards

Hyperthyroidism Flashcards

1
Q

What is the genetic association with hyperthyroidism

A

HLA-B8
HLA-DR2
HLA-DR3

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2
Q

What is the most common cause of hyperthyroidism

A

Grave’s

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3
Q

What are the primary causes of Hyperthyroidism (caused by thyroid dysfunction)

A 
Grave's
Toxic Adenoma
Multinodular Goitre (secrete Thyroid)
Silent Thyroiditis
De Quervain's Thyroiditis(Painful)
Radiation
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4
Q

What are the secondary causes of hyperthyroidism (No thyroid dysfunction)

A 
Amiadorone (Used for AF)
Lithium
TSH producing pituitary adenoma
Choriocarcinoma (Beta HCG activates TSH)
Gestational
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5
Q

What are the peripheral features of Hyperthyroidism

A

Fine tremor
Clubbing
Sweating
Pretibial myxoedema

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6
Q

What is Pretibial Myxoedema

A

excess glycosaminoglycans under the skin

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7
Q

What neck features can be seen typically

A 
Goitre (neck swelling)
Thyroid bruit (sound heard over the thyroid)
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8
Q

What cardiac features are seen in Hyperthyroidism

A

Atrial fibrillation

Heart fail

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9
Q

What is a symptom relief of hyperthyroidism

A

Propranolol (beta blocker)

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10
Q

What medicine is used in hyperthyroidism

A

Carbimazole w/propanolol

Propylthiouracil (thyroid strom)

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11
Q

Pregnancy contraindications of carbimazole and propylthiourail

A

propylthiouracil - use in first trimester

Carbimazole - use in 2nd and 3rd

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12
Q

When should you use radio-iodine therapy

A

In multinodular goitre and adenoma

Avoid with Graves

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13
Q

When should you use thyroidectomy

A

Recurrence
Goitres
Potential Cancer

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14
Q

What are some complications of thyroidectomy

A

Hypoparathyroidism
Hypocalcemia
Laryngeal nerve damage
bleeding

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15
Q

How do you manage a thyroid storm

A

1st = Propylthiouracil with KI

Prednisolone/Propanolol/Digoxin

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16
Q

What aggravates a Thyroid storm (fever, tachycardia, confusion and N+V)

A

Surgery
Trauma
Infection

17
Q

What are complications of Hyperthyroidism

A 
Thyroid storm
Atrial fibrillation
Heart fail
Goitre = Airway obstruction
Grave's Eye diseases
18
Q

What are some features seen with Grave’s eye

A

Exopthalmus (eye bulge)
Periorbital oedema (eye swelling)
Opthalmoplegia (extraocular paralysis)

19
Q

What kind of goitre is seen in Grave’s

A

Smooth symmetrical painless goitre

20
Q

What are the causes of a smooth goitre

A 
Graves
Hashimotos
Drugs( Lithium and amiadorone)
Iodine (high and low)
De Quervain's (Painful)
Infitration (sarcoidosis and Haemochromotosis)
21
Q

What are the causes of a Nodular Goitre

A

Non functional Thyroid Adenoma
Multinodular Goitre
Thyroid cyst
Cancer

22
Q

What are the investigations for Hyperthyroidism

A

Thyroid function test = High T3 AND T4
Beta-hCG = high (use US to find mass)
MRI = Pituitary adenoma?

23
Q

What are the changes between primary and secondary and tertiary TSH, T3 and T4 levels

A

TSH-T3-T4
P = LOW-HIGH-HIGH
S = ALL HIGH

24
Q

What is the action of Carbimazole

A

Inhibits thyroid peroxidase enzyme

25
Q

What are some side effects of carbimazole

A

rash
pruritus
Agranulocytosis with neutropenia

26
Q

Where is the thyroid found

A

C5-T1 Connected w/Isthmus

27
Q

What two arteries supply the thyroid

A

Inferior Thyroid artery (From Subclavian)

Superior Thyroid artery (From ECA)

28
Q

How is T1 and T2 produced

A

Iodine enters colloid
Iodine binds to Tyrosine on Thyroglobulin(by TPO enzyme)
TSH to receptor binding = T1 and T4

29
Q

How is T3 and T4 produced

A

T1 + T2 = T3
T2 + T2 = T4
They move in circulation

30
Q

What is the pathology of Hyperthyroidism

A

TSH-R autoantibodies = Increase Thyroid stimulation

31
Q

What can be given if Carbimazole is CI

A

Propylthiouracil

32
Q

What is the block and reduce method in treating Hyperthyroidism for pregnant women

A

Give antithyroid drug

Give Levothyroxine to prevent HYPOTHYROIDSIM

ENDO (24 decks)

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