Hyperthyroidism and Hypothyroidism Flashcards
what causes primary thyroid disease?
a problem with the thyroid itself
what is the most common cause of primary thyroid disease?
autoimmune diseases
what TFT’s are seen in primary hypothyroidism?
low T3/4
high TSH
what TFT’s are seen in primary hyperthyroidism?
high T3/4
low TSH
what TFT’s are seen in secondary hypothyroidism?
low T3/4
low TSH
what TFT’s are seen in secondary hyperthyroidism?
high T3/4
high TSH
what causes secondary thyroid disease?
problems with the hypothalamus or pituitary
what is another name for TSH?
thyrotropin
which is more abundant - T3 or T4?
T4
what is myxoedema?
very severe hypothyroidism
an emergency
what is pretibial myxoedema?
a rare sign of Grave’s disease
not associated with hypothyroidism
what causes pretibial myxoedema?
build up of GAGs within the collagen
what is the most common cause of primary hypothyroidism?
hashimoto’s thyroiditis
what is hashimoto’s thyroiditis?
autoimmune destruction of the thyroid gland causing reduced thyroid hormone production
who is most commonly affected by hashimoto’s thyroiditis?
women
what antibodies are produced in hashimoto’s thyroiditis?
antibodies against thyroid peroxidase
what is the management for hypothyroidism?
levothyroxine
who is the typical patient affected by myxoedema coma?
elderly women with longstanding but untreated hypothyroidism
what is thyrotoxicosis?
the clinical state arising when the tissues are exposed to excess thyroid hormone
what is hyperthyroidism?
conditions that lead to thyrotoxicosis
who is more commonly affected by grave’s disease?
women
what is an important risk factor for grave’s disease?
smoking
what is the first line drug for hyperthyroidism?
carbimazole
when is propylthiouracil first line for hyperthyroidism?
only in the first trimester of pregnancy
what is a rare but serious potential complication of anti-thyroid drugs?
agranulocytosis
what is the first line beta blocker considered for hyperthyroidism?
propranolol
used for immediate symptomatic relief
what is the first line management for relapsed grave’s disease and nodular thyroid disease?
radioiodine
when is radioiodine contraindicated?
in pregnancy
active thyroid eye disease - can be given with steroid cover
what is thyroiditis?
inflammation of the thyroid
name two drugs that could potentially cause thyroiditis
amiodarone
lithium
what blood results are seen in subclinical hypothyroidism?
raised TSH
normal T3/T4
when is treatment recommended for subclinical hypothyroidism?
TSH >10
in pregnancy
what blood results are seen in subclinical hyperthyroidism?
low TSH
normal T3/T4
what conditions can subclinical hyperthyroidism be associated with?
multinodular goitre
osteoporosis
AF
when is treatment advised for subclinical hyperthyroidism?
TSH <0.1
or if co-existing osteoporosis/AF
what is another name for non-thyroidal illness?
sick euthyroid syndrome
who is often affected by sick euthyroid syndrome?
unwell hospitalised patients
what does sick euthyroid syndrome refer to?
the impact of intercurrent illness on the HPT axis
describe the thyroid hormone levels seen in sick euthyroid syndrome
TSH suppressed initially, rises during recovery
