hypo/hyperthyroidism Flashcards
graves diseases is an autoimmune form of ____, causing an increased basal metabolic rate. There are many different effects on the body, tachy__, insomnia, ___ intolerance, (GI: ___,___) tremors and amenorrhea(?)
You may also see pretibial __ - what?, ptosis
hyperthyroidism tachycardia heat intolerance diarrhoea lose weight
amenorhea - no periods
myxoedema - colourful plaques on anterior shin, bilateral, shiny, firm and non-pitting
if grave disease suspected, which antibodies can be measured
Thyroid stimulating hormone receptor antibodies (TRAB)
in hyperthyroidism, circulating levels of TSH would be high/low, and T4/4 high/low
TSH – LOW
T4 T3 - HIGH
3 assoc autoimmune diseases of HyperT
vitiligo
addisons
T1DM
treatment for hyperthyroidism - __ __ for symptomatic relief, carbimazole - __ drug, radio-___ and surgery
beta blockers
antithyroid
iodine
toxic multinodular goitre is typically seen in __ patients, there will be an excess production of thyroid hormones with multiple overactive __
older
nodules
toxic adenoma secretes __, it is a __ hot nodule - seen on ___ scan. Trear with ___
T3
single
isotope
radioiodine
hyperT can also be caused by subacute thyroiditis. This is a self-limiting __ infection, is the goitre painful?
The patiet will most likely havw a fever, raised__ markers and a __ isotope uptake on scan
viral
yes
inflam
low
thyroid crisis is life threatening y/n it is precipitated by surgery, acute illness or \_\_ \_\_ clinically: temperature \_\_ seizures \_\_\_ \_\_\_ restlessness \_\_\_ \_\_\_
treat with (4)
assoc complications?
yes
iodine therapy
> 38.5
vomiting
sweating
jaundice confusion
treat: propanolol high dose digoxin carbimazole hydrocortisone/dexamethasone
shock - coma - death
if hypoT is decreased metabolic rate, give signs (12)
autoimmune disease causing this? what AB will be present
bradycardia fatigue weight gain constipation pale/cold skin cold intolerance menorrhagia thin, dry hair carpal tunnel syndrome hyperlipidaemia pitting oedema
hashimoto’s thyroiditis
TPO
(tcell mediated, commoner in older woman)
askanazy cells are seen in
hashimotos thyroiditis
other than hashimotos thyroiditis, give 3 primary causes and 3 secondary causes
atrophic thyroiditis - diffuse lymphocyric infiltration
iodine deficiency
prev. treatment for hyperthyroidism
2ndary pit tumour sheehans syndrome -hypopit caused by ischaemic necrosis + hypovolaemic shock after childbirth (BABIES + hypoT = SHEEHANS) trauma
treatment of hypoT
slow restore of thyroid levels
levothyroxine
TFT monitored every 2 months
__ is a medical emergency of hypothyroidism, it is caused by an unsuspected hypoT. Clinically - hypo - thermia/tension/glycaemia/natraemia/xia
hypercapnia
bradycardia
myxoedema coma
pregnancy - which hormone made by he foetus mimics TSH and prevents degeneration of corpus luteum
HcG
