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Endocrine > Hypothyroidism > Flashcards

Hypothyroidism Flashcards

1
Q

What is hypothyroidism?

A

Insufficient production of the thyroid hormone by the thyroid gland

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2
Q

What is the most common cause of hypothyroidism in the developing world?

A

Iodine deficiency

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3
Q

What is the most common cause of hypothyroidism in the developed world?

A

Hashimoto’s thyroiditis

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4
Q

What is Hashimoto’s thyroiditis?

A

Autoimmune inflammation of the thyroid gland

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5
Q

What are drug causes of hypothyroidism?

A

Amiodarone

Lithium

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6
Q

What are possible RF for hypothyroidism?

A

Down’s syndrome
Coeliac
Turner’s syndrome

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7
Q

How does hypothyroidism present?

A 
Weight gain
Lethargy
Cold intolerance 
Dry skin
Constipation 
Hoarse voice
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8
Q

What can happen to hair in hypothyroidism?

A

Dry, coarse scalp hair

Loss of lateral aspect of eyebrows

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9
Q

What antibodies are present with Hashimoto’s?

A

Anti-thyroid peroxidase antibodies

Anti-thyroglobulin antibodies

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10
Q

What is the TSH and T3, T4 level in Primary hypothyroidism?

A

High TSH

Low T3 and T4

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11
Q

What is the TSH and T3, T4 level in subclinical hypothyroidism?

A

High TSH, normal T3 and T4

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12
Q

What is the medical management of hypothyroidism?

A

Levothyroxine

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13
Q

How would you change the dose of levothyroxine if the patient was elderly?

A

Reduce the dose

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14
Q

What should you after changing the dose of levothyroxine?

A

Check TFT’s in 8-12 weeks

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15
Q

How would you change the dose of levothyroxine in someone who was pregnant?

A

Increase dose by 25-50mg

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16
Q

What is a side effect of over-treatment with levothyroxine?

A

hyperthyroidism

17
Q

What can reduce the absorption of levothyroxine?

A

Iron tablets
Calcium carbonate tablets

(give 4 hours apart)

18
Q

What is the therapeutic goal of levothyroxine?

A

A normal TSH

19
Q

What is secondary hypothyroidism?

A

Pituitary gland doesn’t produce enough TSH

20
Q

What are possible causes of secondary hypothyroidism?

A

Tumours
Infection
Vascular- Sheehan’s

21
Q

What is a complication of undiagnosed hypothyroidism or poor compliance to medication?

A

Myxoedemic coma

22
Q

How does a myxoedema coma present?

A 
Unconscious 
Overweight 
Dry skin 
Hypotensive
Thin and brittle hair
Periorbital oedema
23
Q

What is the management of myxoedemic coma

A

IV thyroxine
IV fluid
IV hydrocortisone (until adrenal insufficiency has been excluded)

24
Q

What is the TSH, T3 and T4 level in subclinical hypothyrodism?

A

TSH raised

T3 and T4 are normal

25
Q

What is there the risk of developing in subclinical hypothyroidism?

A

Hypothyroidism

26
Q

What would you do with someone with subclinical hypothyroidism and asymptomatic?

A

Observe and repeat thyroid function in 6 months

27
Q

In who would the starting dose of levothyroxine be lower?

A

Elderly
Ischaemic Heart Disease

28
Q

What should the initial starting dose be for people with cardiac disease or over 50 be?

A

25mcg od with dose slowly titrated

29
Q

What is the normal starting dose of levothyroxine be in other patients?

A

50-100mcg od

30
Q

What are the other potential side effects of levothyroxine?

A

hyperthyroidism: due to over treatment
reduced bone mineral density
worsening of angina
atrial fibrillation

31
Q

What gynaecological problem can hypothyroidism cause?

A

Menorrhagia

32
Q

What neurological probelms can hypothyroidism cause?

A

Decreased deep tendon reflexes
Carpal tunnel syndrome

33
Q

What can occur in the hands and face in someone with hypothyroidism?

A

Non-pitting oedema (puffy face)

34
Q

What cardiac symptoms can hypothyroidism cause?

A

Bradycardia
Cardiomegaly​

35
Q

What cancer is hasimoto’s thyroiditis associated with?

A

Thyroid lymphoma

36
Q

How can a thyroid lymphoma present?

A

solitary, painless, hard, immobile nodule at the front of her neck- Doesn’t move on tongue protrusion.

Endocrine (27 decks)

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