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MSPA-Endocrinology > Hypothyroidism > Flashcards

Hypothyroidism Flashcards

1
Q

What is primary hypothyroidism and its lab findings ?

A

It is the dysfunction of the follicular cells of the thyroid gland leading to low T3 and T4 with High TSH. This leads to hypo metabolism and stimulation of fibroblasts which triggers the deposition of glycosaminoglycans in the interstitium of the skin and soft tissue.

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2
Q

What is central hypothyroidism ?

A

It is caused by the dysfunction of adenohypophysis or hypthalamic neurons responsible for producing TRH.
https://www.invitra.com/en/wp-content/uploads/2020/11/types-of-hypothyroidism.png

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3
Q

what are the clinical features of low BMR in hypothyroidism?

A

Modest weight gain and cold intolerance.

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4
Q

What are the dermal findings in Hypothyroidism ?

A

Cool skin due to vasoconstriction and dry skin due to dysfunction of sebaceous glands.

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5
Q

What are the hair and nail findings in Hypothyroidism ?

A

Brittle hair with diffuse allopecia and brittle nails.

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6
Q

What is the cause of non-pitting edema in hypothyroidism ?

A

The deposition of glycosaminoglycans within the interstitium increases osmotic pressure leading to non-pitting edema, facial myxedema, and periorobital edema.

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7
Q

What are the GI findings in Hypothyroidism ?

A

Constipation and reduced appetite.

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8
Q

What are the clinical features of hypothyroid myopathy ?

A

Proximal weakness and elevated CK due to muscle damage.

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9
Q

What is the cause of carpel tunnel syndrome in Hypothyroidism ?

A

Glycosaminoglycan deposit.

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10
Q

What is myoedma of Hypothyroidism ?

A

It is the percussion induced formation of a transient bump on the muscle.

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11
Q

What are the reproductive findings in Hypothyroidism ?

A

Mennorahgia, oligomenorrhea, low libido and infertility due to low LH.

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12
Q

What are the cardiac findings in Hypothyroidism ?

A

Bradycardia, low cardiac output and exertional dyspnoea.

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13
Q

What is the cause of hypercolesterolemia in Hypothyroidism ?

A

Low LDL expression.

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14
Q

What are the autoimmune causes of Hasimotto’s thyroiditis ?

A

Infiltration of the thyroid gland by the Anti-thyroid peroxide ( anti-microsomal antibody )and thyroglobulin antibodies.

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15
Q

What HLA gene is responsible for mediating the autoimmune process in Hashimotto’s ?

A

HLA DR3

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16
Q

What causes thyromegaly in Hashimotto’s disease ?

A

It is the compensatory hypertrophy and hyperplasia of the follicular cells of the thyroid gland.

17
Q

What is the initial and late hormonal response pattern in Hasimotto’s disease ?

A

In the initial stage the compensatory follicular hypertrophy and plasia will cause hyperthyroidism followed by exhaustion of the follicular cells leads to hypothyroidism.

18
Q

What are the histological marker of Hashimotto’s disease ?

A
  • Hurtle cells also known as Oncocytes which are eosinophilic with large neucleolus and vesicular neucli.
  • Lymphoid aggregates with germinal centers.
19
Q

What is the risk of Hashimotto’s disease ?

A

Lymphoma.

20
Q

What are the 3 phases of subacute granulomatous thyroiditis ?

A

A= Hyperthyroidism
B= Hypothyroidism
C= normothyroidism.

21
Q

What are the histologic findings in subacute granulomatous thyroiditis ?

A

Early phase - Destruction of follicular cells and colloid depletion with neutrophilic infiltration.
Late phase - Granulomatous inflammation.
labs will show high ESR.

22
Q

What is Riedel thyroidits ?

A

It is part of the IgG 4 disease that causes chronic thyroid inflammation that causes thyroid fibrosis.

23
Q

Why is Reidel thyroiditis is mistaken for anapalstic thyroid cancer ?

A

The fibrous thyroid tissue can invade the local structure mimicking anapalstic thyroid carcinoma.

24
Q

What is the histology of post-partum thyroiditis ?

A

Lymphocytic infiltration of the thyroid with occasional germinal centres.

25
Q

What are the cause of congenital hypothyroidism or cretinism ?

A
  • The most common cause is thyroid dysgenesis.
  • Anti-body mediated maternal hypothyroidism.
  • Thyroid dysgenesis.
  • Iodine deficiency
  • Dyshormono-genetic goiter.
26
Q

What are the 6 P’s of congenital hypothyroidism ?

A

Potbelly
Pale
Puffy face
Protruding umbaliccus
Protuberant tongue
Poor brain development

27
Q

What are the medications that inhibit thyroid hormone production ?

A

Amiodarone, Lithium, and Sulfonamides.

MSPA-Endocrinology (10 decks)

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