HYPOTHYROIDISM Flashcards
Effects of hypothyroidism in children and infant
Impairs intellectual and physical development
Cretinism
Effects of hypothyroidism in adults
Heart disease
Menstrual irregularities
Infertility
Mental health conditions
Dementia
Iodine replacement is the treatment for hypothyroidism. T/F
False
Iodine replacement is the treatment for hypothyroidism. T/F
False
When is screening for hypothyroidism encouraged
New borns
Every five years after 35 years of age especially in females
When is screening for hypothyroidism encouraged
New borns
Every five years after 35 years of age especially in females
…… is used for screening of hypothyroidism
TSH
Causes of hypothyroidism
Antibody-related thyroid gland destruction
Subtotal thyroidectomy
Pituitary surgery or lesions
Congenital
Severe iodine deficiency
Drug induced
Symptoms of hypothyroidism
General weakness and tiredness
Intolerance to cold
Constipation
Weight gain
Hair loss
Dry skin
Hoarse voice
Memory loss
Goitre may be present
Abnormal menstrual periods and sub-fertility (in adult females)
Poor growth, development and poor school performance in children
Signs of hypothyroidism in neonate
Prolonged neonatal jaundice
Excessive sleep
Feeding problems
Signs of hypothyroidism in children
Cretinism
Signs of hypothyroidism in children
Cretinism
Signs of cretinism
mental subnormality
short stature
large tongue
dry skin
sparse hair
protuberant abdomen
umbilical hernia
abnormal faecies
Signs of cretinism
mental subnormality
short stature
large tongue
dry skin
sparse hair
protuberant abdomen
umbilical hernia
abnormal faecies
Signs of hypothyroidism in adults
Slow pulse (usually <60 per minute)
Dry coarse skin
Puffy face
Pallor
Hoarse voice
Slow reflexes
Dementia
Goitre may be present
Investigations in hypothyroidism
To correct blood level of thyroid hormones
To maintain lifelong normal levels of thyroid hormones
Investigations in hypothyroidism
To correct blood level of thyroid hormones
To maintain lifelong normal levels of thyroid hormones
Initiating treatment of hypothyroidism
Start treatment with a low dose of levothyroxine, especially in the elderly and children as well as individuals with heart disease (e.g. 25-50 microgram), and adjust dose as appropriate every 6-8 weeks until TSH levels are within normal
reference range
It is advisable to initiate levothyroxine at low dosr in these populations
Elderly
Children
Heart disease
It is advisable to initiate levothyroxine at low dosr in these populations
Elderly
Children
Heart disease
Dose of levothyroxine
Levothyroxine, oral,
Adults
25-200 microgram daily
Children
> 12 years; 25 microgram daily (max. 200 micrograms)
2-12 years; 25 microgram daily (max. 100 micrograms)
< 2 years; 25-75 micrograms daily
Referral criteria for hypothyroidism
Diagnosed or suspected cases of all ages, especially children with intellectual impairment, and individuals with pituitary disease