Hypothyroidism Flashcards

1
Q

What are the Risk Factors for Hypothyroidism? (2 things)

A
  1. Age
  2. Female
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2
Q

What are the causes of Hypothyroidism? (7 things)

A
  1. Hashimoto’s Thyroiditis (most common cause)
  2. Iodine Deficiency (most common cause in developing world)
  3. Secondary to Hyperthyroidism Treatment
  4. Lithium
  5. Amiodarone
  6. Pituitary failure (2ndary Hypothyroidism)
  7. Down’s / Turner’s Syndrome (2ndary Hypothyroidism)
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3
Q

How does Lithium cause Hypothyroidism?

A

Inhibits thyroid hormone production in Thyroid gland

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4
Q

How does Amiodarone cause Hypothyroidism?

A

Reduces T4 –> T3 conversion

(can also cause Hyperthyroidism)

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5
Q

What is Hashimoto’s Thyroiditis?

A

Chronic AI condition –> Thyroid destruction –> Hypothyroidism

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6
Q

What is the Pathophysiology of Hashimoto’s Thyroiditis? (2 things)

A

AI thyroid cell destruction by:

  1. CD8+ Cytotoxic T cells destroy thyroid cells
  2. Antibodies clart:
  • TSH receptors
  • Thyroglobulin (Tg)
  • Thyroid Peroxidase (TPO)
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7
Q

What are the CF of Hypothyroidism? (12 things)

A
  1. Memory loss
  2. Obesity (weight gain) (puffy face + hands + feet)
  3. Malar flush (red cheeks) / Menorrhagia (heavy periods)
  4. Infertility
  5. Slowness (mentally + physically)
  6. Skin + Hair dryness
  7. Onset = gradual / 0 poos (constipation)
  8. Tiredness
  9. Intolerance to cold
  10. Raised BP / Reduced Appetite
  11. Energy levels dip
  12. Depression

MOM IS SO TIRED

Hypothyroidism everything low low

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8
Q

What investigations should you do for sus Hypothyroidism? (3 things)

A
  1. TSH levels (HIGH in Primary / LOW in Secondary)
  2. T3 + T3 levels (LOW)
  3. Antibodies (Tg / TPO / TSH Receptor) (HIGH in Hashimoto’s)
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9
Q

Why will TSH levels be HIGH in Primary Hypothyroidism?

A

Bc low T3 n T4 levels doing -ve fdbk on Pit

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10
Q

What pregnancy problems can Hypothyroidism lead to? (6 things)

A
  1. Infertility
  2. Eclampsia (high BP –> seizures in pregnancy)
  3. Prematurity
  4. Low birthweight
  5. Stillbirth
  6. Postpartum hemorrhage (PPH) (heavy bleeding after birth)
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11
Q

What are the management options for Hypothyroidism?

A

Oral levothyroxine (thyroid hormone replacement)

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12
Q

What is Levothyroxine?

A

Synthetic T4

Metabolises to T3 in body

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13
Q

What should you do when giving Levothyroxine?

A

Measure TSH levels monthly bc it tells you if you need to up / reduce dose

(If TSH too HIGH = increase Levothyroxine dose)

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14
Q

What are the Side Fx of Levothyroxine? (4 things)

A
  1. Hyperthyroidism:
  2. Reduced bone mineral density
  3. Worsening of angina
  4. AF
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15
Q

What are the complications of Hypothyroidism? (3 things)

A
  1. Myxoedema Coma (severe hypothyroidism)
  2. Other AI conditions (T1DM)
  3. B Cell Lymphoma of Thyroid gland
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16
Q

What is Myxoedema Coma (severe hypothyroidism)? (4 things)

A
  1. Severe hypothyroidism
  2. Characterized by slowing function of beh organs
  3. Medical emergency
  4. Can –> Shock + death (50% mortality)