Hypothyroidism Flashcards
How common is hypothyroidism?
- Common 4/1000 yr
2. Women more common
What are different types of primary hypothyroidism?
- Atrophic primary hypothyroidism
- Hashimoto’s thyroiditis
- Other
What happens in atrophic primary hypothyroidism?
- Common
- Diffuse lymphocytic infiltration of the thyroid
- Leading to atrophy – no goitre
What happens in Hashimoto’s thyroiditis?
- Goitre due to lymphocytic and plasma cell infiltration
2. Common women 60-70
What are the other causes of hypothyroidism?
- Iodine deficiency
- Post-thyroidectomy or radioiodine treatment
- Drug-induced e.g lithium, amiodarone
- Subacute thyroiditis
What happens in secondary hypothyroidism?
not enough TSH – due to hypopituitarusn
Is it true having one autoimmune condition makes others more common?
yes
What are symptoms of hypothyroidism?
- Tiredness
- Sleepy
- Low mood
- Menorrhagia
- Hoarse voice
- Low memory/cognition
What is pneumonic to remember signs of hypothyroidism?
bradycardia
What are signs of hypothyroidism?
- Bradycardia
- Reflexes slow
- Ataxia
- Dry thin hair
- Yawning
- Cold Hands
- Ascites
- Round puffy face
- Defeated demenour
- Immobile
- CF (cardiac failure)
What are some DDx of hypothyroidism?
- Central or secondary hypothyroidism
- Depression
- Alzheimer’s dementia
- Anameia
What investigations would you do for hypothyroidism?
TFTs, FBC
What are TFT levels in primary hypothyroidism?
TSH: elevated
T3, T4: low
What are TFT levels in hypothyroidism?
TSH: low
T3 T4: low
What is the management plan for hypothyroidism?
-Levothyroxine (T4)
-Thyroxine t1/2 is 7 days so wait 4 weeks to check
100mcg/24h
