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Endocrine AM > Hypothyroid > Flashcards

Hypothyroid Flashcards

1
Q

What are the types of causes of hypothyroid?

A

Subclinical
Primary
Secondary

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2
Q

What is subclinical hypothyroid?

A

Raised TSH but normal T3 and T4

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3
Q

What is primary hypothyroid caused by?

A

Thyroid pathology

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4
Q

What are the TSH and T4 levels in primary hypothyroid?

A

Raised TSH

Low T4

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5
Q

What are the causes of primary hypothyroid?

A

Congenital- developmental, dyshormogenesis

Acquired- autoimmune, iatrogenic, chronic iodine sufficiency, sub-acute thyroiditis

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6
Q

What is autoimmune hypothyroid?

A

Hashimotos

Thyroid peroxidase antibodies

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7
Q

What causes secondary hypothyroid?

A

Pituitary pathology

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8
Q

What are the TSH and T4 levels in secondary hypothyroid?

A

Low TSH and T4

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9
Q

What are causes of secondary hypothyroid?

A

Pituitary tumour
Craniopharyngioma
Post pituitary surgery/radiotherapy
Sheehan’s

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10
Q

What is the presentation of hypothyroid?

A 
Weight gain
Constipation
Heavy periods
Feeling cold
Lethargy
Dry skin/hair
Bradycardia
Slow reflexes
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11
Q

What are the signs of severe hypothyroid?

A

Puffy face
Hoarse voice
Large tongue
Coma

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12
Q

What investigations are done for hypothyroid?

A

TFTs
Autoantibodies
FBC, U&Es

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13
Q

What autoantibodies are present in HAshimoto’s?

A

Thyroid peroxidase antibodies

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14
Q

What can FBC and U&Es show in hypothyroid?

A

Hypercholesterolaemia
Hyponatraemia
High creatinine

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15
Q

What is the management of hypothyroid?

A

Levothyroxine
-start on 50mcg, increase to 100mcg after 2 weeks, monitoring TFTs and increasing dose until normalised
Monitor TFTs annually

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16
Q

In who is management of hypothyroid different?

A

Elderly, IHD
Pregnancy
Post partum thyroiditis

17
Q

What are the management principles of hypothyroid in elderly or those with IHD?

A

Start low and go slow

18
Q

What are the management principles of hypothyroid in pregnancy?

A

Higher dose normally required and keep T4 in high range

19
Q

What are the consequences of hypothyroid in pregnancy?

A

Increased risk of foetal loss and Low IQ

20
Q

What is the management of postpartum thyroiditis?

A

Withdraw levothyroxine for 6 weeks and measure TFTs after 6 weeks

21
Q

When should treatment of subclinical hypothyroid be considered?

A

TSH >10
TSH >5 with + antibodies
TSH elevated and symptomatic

22
Q

What are the possible complications of hypothyroid management?

A

Osteopenia
AF
Angina in those with IHD

Endocrine AM (9 decks)

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