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endocrine > hyperthyroidism > Flashcards

hyperthyroidism Flashcards

1
Q

most common cause of hyperthyroidism?

A

graves disease

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2
Q

graves disease usually presents in ?

A

women aged 40-60

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3
Q

what causes increased T3/T4?

A

production of antibodies that stimulate T3/4 production and release in the absence of TSH

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4
Q

what are the autoantibodies seen in graves disease?

A

TRAB
Anti thyroid peroxidase
anti thyroglobulin

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5
Q

what kind of goitre do you get?

A

smooth, symmetrical goitre

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6
Q

specific signs of graves?

A

pretibial myxoedema

bilateral exopthalmos and opthalmoplegia

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7
Q

who is nodular disease more commonly seen in ?

A

elderly patients

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8
Q

what does nodular disease result in ?

A

toxic multinodular goitre

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9
Q

what is a toxic multi nodular goitre?

A

multiple nodules that secrete thyroid hormone

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10
Q

whats a toxic adenoma?

A

single nodule that secretes thyroid hormone and suppresses activity of the rest of the gland

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11
Q

inflammatory cause of thyroiditis?

A

sub acute DeQuervains Thyroiditis

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12
Q

sub acute de quervains is a transient inflammation of the thyroid gland. when would this occur?

A

after a viral illness

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13
Q

what happens in DQT?

A

patients tend to cycle from hyper to hypo then back to normal

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14
Q

treatment of DQT?

A

NSAIDS

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15
Q

what is DQT associated with >

A

painful goitre, pyrexia and raised inflammatory markers

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16
Q

GI symptoms?

A

diarrhoea

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17
Q

motor?

A

tremor

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18
Q

CVS?

A

palps

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19
Q

GU

A

oligomennorhea +- infertility

20
Q

derm?

A

moist skin or lumps on shins

21
Q

mood?

A

anxiety, irritability, emotional liability, psychoss

22
Q

general?

A

heat intolerance, sweating, fatigue, weight loss, increased appetite, reduced conc, swelling in the neck

23
Q

ophthalmology?

A

gritty sensation in eye, eye discomfort, double vision, photophobia

24
Q

pre tibial myxoedema - hyper or hypo?

A

hyper - shin on grave

25
Q

ophthalmology signs

A

lid lag
lid retraction
chemosis (swelling of the conjunctive)
exopthalmos - protrusion of the eye (GRAVES ONLY)

26
Q

diagnosis of hyperthyroidism?

A

TFTs, +- antibodies +- scintigraphy scan

27
Q

what does pre tibial myxoedema?

A

purple brown/ indurated plaques on shin

28
Q

High TSH and high T3/4?

A

secondary hyperthyroidism

29
Q

TSH and T3/4 level in primary hyper?

A

high T3/4, low TSH q

30
Q

scintigraphy results

High uptake in multiple locations.

A

multi nodular

31
Q

Single nodule of high uptake.

A

toxic adenoma

32
Q

Reduced uptake.

A

de quervains

33
Q

Diffuse, increased uptake.

A

graves

34
Q

symptom control management of hyperthyroid?

A

propranolol

35
Q

two anti thyroid medications

A

carbimazole and propylthiouracil

36
Q

which drug is favoured in pregnancy

A

PTU

37
Q

what is there a risk of in carbimazole ?

A

agranulocytosis

38
Q

what is used in radio ablation

A

radioactive iodine

39
Q

what are the risks of radio ablation?

A

thyroid storm in active disease

post treatment hypothyroidism

40
Q

contraindications to radio ablation

A

pregnancy, lactation

41
Q

what is a thyroidectomy?

A

o Surgical removal of part or all of the thyroid gland.

42
Q

risks of thyroidectomy?

A

recurrent laryngeal damage and hoarseness, hypothyroidism, hypoparathyroidism

43
Q

how does carbimazole work?

A

These drugs decrease the output of thyroid hormones from the thyroid gland by reducing the action of the peroxidase enzyme – thus preventing iodine from joining with tyrosine – which is what normally happens before the tyrosine is excreted from the cell and incorporated into a thyroglobulin molecule

44
Q

how long does it take for carbmiazole to work and what can be done in this time to

A

3-4 weeks

45
Q

what is given in this time to control symptoms ?

A

beta blockers

endocrine (27 decks)

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