Hypothyroidism Flashcards
primary hypothyroidism levels?
low T3, T4, TSH raised
secondary hypothyroidism levels?
low T3, T4 TSH
causes of hypothyroidism (primary)?
hashmitos
iodine deficiency
medication for hyperthyroidism ( carbimazole, propylthiouracil, radioactive iodine, thyroid surgery, lithium and amiadarone)
which antibodies can be found in hashimotos?
anti thyroid peroxidase (anti-TPO), anti thyroglobulin (anti-Tg)
what does lithium do?
inhibits production of thyroid hormones causing goitre/ hypothyroidism
how does amiodarone cause?
interferes with thyroid hormone production and metabolism
causes of 2nd hypothyroidism?
tumours (pituitary adenomas)
surgery
radiotherpay
sheehans syndrome
trauma
what is sheehans syndrome?
postpartum hypopituitarism caused by necrosis of the pituitary gland
presentation of hypothyroidism?
weight gain, cold intolerance, fatigue, dry skin, coarse hair/loss, fluid retention (pleural effusion, ascites, oedema), heavy or irregular period constipation, carpal tunnel syndrome, decreased deep tendon reflexes, hoarse voice
management of hypothyroidism?
levothyroxine T4
liothyronine sodium synthetic T3 when levothyroxine not tolerated
hasmitos is associated with?
IDDM, addisons pernicious anaemia
hashmitos may cause?
transient thyrotoxicosis in acute phase
other causes of secondary hypothyroidism besides pituitary failure?
Down’s, Turner’s coeliac
dose of levothyroxine?
50-100 mcg od
25mcg in cardiac disease, severe hypothyroidism or patients over 50 years
thyroid function tests should be checked x weeks after change in thyroxine dose?
8-12 weeks
