hypothyroidism Flashcards
hypothyroidism causes 1
congenital, defects of hormone synthesis, autoimmune, post subacute thyroiditis
features of congenital hypothyroidism
pale, puffy face, protruding tongue, protruding umbilicus, poor brain development, prolonged neonatal jaundice
congenital 1
ectopic thyroid remnants, agenesis, dysgenesis, dyshormone genetic goiter (decreased TPO),
defects of hormone synthesis causes
iodine deficiency, dyshormonogenesis, lithium, amiodarone
autoimmune hypothyroidism
Hashimoto’s, atrophic, postpartum, rieoeuls thyroiditis’s
Hashimoto’s thyroiditis definition
chronic lymphodtyic thyroiditis
hashimotos thyroiditis risk factors
HLADR3/5, glucotoicoids, anabolic steriods, excessive iodine intake, female
antibodies in hasimotos
anti TPO, anti TG
hastimotos spesific symptoms
pertibial myxedema, periorbital myxedema, painless, hard, smooth goiter
atrophic thyroiditis pathophysis
TSH receptor autoantibodies -> atrophy + fibrosis
postpartum thyroiditis pathophysis
within 1 year of a birth, acute, self resolving, TPO, TG antibody
subacute granulomatous thyroiditis/de quervains features
high ESR, hyperthyroidism -> hypothyroidism, self resolving, flu like symptoms, painful thyroid
secondary hypothyroidism causes
hypothalamus tumour/trauma (decreased TRH), anteiro pituitary -> no TSH (sheehanand syndrome)
hypothyroidism symptoms
decreased metabolism (weight gain, cold intolerance, decreased appetite), bradycardia, vasoconstriction (hypertension), short stature, decreased SNS (fatigue, memory loss, lethargy, depression, delayed deep tendon reflex), muscle aches, proximal muscle weakness, raised CK, not enough blood to skin (dry skin, brittle nails, hair loss (of eye brows), hyperlipidemia, GAG not broken down (pretibial myxedema, periorbital oedema, carpal tunnel syndrome, high TSH (riases prolactin -> testoerone + estrogen -> gynocmstea, menstrual distubances + decreased libido)
investigation of hypothyroidism
1 (TSH high, T4 low), 2 (THS low, T4 low), TPO + TP antibodies, serum TG ( high in hashimotos), idodine levels
treatment
levothyroxine (estrogen decreases T4, corticosteroids increase T4
associated condition of hypothyroidism
high LDL, high CK, hypoglycemia, hypotonic hyponatremia
myxoedema coma triggers
infection, surgery, trauma, extreme cold
symptoms
bradycardia, hypotension, altered mental status, hypoglycaemia, hyperthermia
myxoedema coma treamtent
IV T4, IV fluids, IV hydrocortisone until addisonian crisis ruled out