Hypothyroidism Flashcards
what happens to T4 levels?
↓T4
most common cause of hypothyroidism?
Hashimoto’s thyroiditis
is hashimoto’s thyroiditis primary or secondary?
1° thyroid failure
what type of disease is hashimoto’s thyroiditis?
autoimmune
in hashimoto’s thyroiditis which leukocytes are involved?
T lymphocytes
T lymphocytes attack what gland in hashimoto’s thyroiditis?
thyroid gland
90% of people hashimoto’s thyroiditis have what antibodies?
anti-TPO antibodies
what hypothyroidism is this:
fibrous tissue replaces normal thyroid tissues, get a pain less goitre?
Riedel thyroiditis
which drugs can cause hypothyroidism?
-2
lithium and amiodarone
Inborn errors of thyroid hormone synthesis are called what?
Congenital hypothyroidism
which surgery/procurers can cause hypothyroidism?
-2
resected thyroid or irradiation
which element do you need to make thyroid hormone?
Iodine
most common cause of hypothyroidism in developing worlds
Iodine deficiency
Hashimoto’s thyroiditis more common in females or males?
females
which hypothyroidism can only occur in females?
Postpartum thyroiditis
can hypothyroidism be idiopathic?
yes
can you get goitre in Hashimoto’s thyroiditis?
yes
will goitre in hashimoto’s thyroiditis be tender?
no
character of goitre in hashimoto’s thyroiditis?
-2
firm, non tender
hashimoto’s thyroiditis is assoc with what other autoimmune diseases?
-3
coeliac disease, T1DM, vitiligo
hashimoto’s thyroiditis is how many x more common in females?
10x
Define goitre?
swollen neck from enlarged thyroid gland
what gutturia (latin) mean literally?
throat
define diffuse goitre?
entire thyroid gland swollen
define nodular goitre?
small lumps on thyroid gland
how do diffuse goitre and nodular goitre differ when you feel them?
diffuse goitre - not lumpy
nodular goitre - lumpy
define non-toxic goitre?
thyroid function is normal
define toxic goitre?
thyroid function abnormal
why is goitre made essentially in hypothyroidism?
compensate for low TH
effect of iodine on the thyroid cells?
hyperplasia
step by step how can I- Deficiency lead to goitre?
I- Deficiency > ↓T4 & T3 levels > ↑TSH to compensate > iodine influx into thyroid gland > thyroid cell hyperplasia > goitre made
Congenital Hypothyroidism:
how many neonates are affected?
1/4000 neonates
why is congenital hypothyroidism an emergency?
If not treated within first 4 week you get irreversible cognitive impairment
how to screen for congenital hypothyroidism?
heel prick test
what happens to tone in congenital hypothyroidism?
hypotonia
what happens to skin in congenital hypothyroidism?
jaundice
what happens to tongue in congenital hypothyroidism?
macroglossia
congenital hypothyroidism:
what are the extra features?
-6
jaundice
short stature
puffy face, macroglossia, hypotonia
delayed physical and mental milestones
is riedel’s thyroiditis
rare or common?
Very rare
in riedel’s thyroiditis how will goitre feel?
-2
hard painless goitre
how does thyroid gland change in riedel’s thyroiditis?
dense fibrous tissue replaces normal thyroid tissue
in riedel’s thyroiditis as goitre grows what will eventually happen?
compression on nearby structures
compressive symptoms from goitre?
-6
hoarseness dysphagia stridor dyspnoea choking cough
Treatment for riedel’s thyroiditis?
-2 things
prednisolone + surgery to resect some thyroid
Definition of Subclinical Hypothyroidism?
normal T4 but ↓TSH
Cause of subclinical hypothyroidism?
multinodular goitres
which gender is effected more by subclinical hypothyroidism?
females
prognosis for subclinical hypothyroidism?
usually TSH goes back to normal spontaneously
treatment for subclinical hypothyroidism if TSH still low after a while?
low-dose antithyroid agents for 6 months
hypothyroidism:
main gut symptom?
Constipation
hypothyroidism:
mood change?
-1
Depressed
hypothyroidism:
weight changes?
weight gain
hypothyroidism:
symptom that effects women only?
Menorrhagia
define Menorrhagia?
heavy periods
symptoms of hypothyroidism?
-6
Constipation Cold Tired Depressed Weight gain No eyebrows
hypothyroidism 1° to thyroid gland.
what are the TFT results?
↓T4 ↑TSH
hypothyroidism 2° to thyroid gland.
what are the TFT results?
↓T4 ↓TSH
pt has normal T4 and ↓TSH.
what condition is this?
subclinical hypothyroidism
pt has hypothyroidism.
U+E changes?
-2
↓Na+
↑CK
pt has hypothyroidism.
LFT changes?
-2
↑bilirubin, ALT
pt has hypothyroidism.
what happens to LDH?
↑
what does LDH stand for?
Lactate dehydrogenase
1st line IX to see goitres?
US
mainstay drug for hypothyroidism?
levothyroxine
Levothyroxine is an analogue of what hormone?
T4
If hypothyroidism untreated it can lead to what emergency?
myxoedema Coma
