Hypothyroidism Flashcards
1
Q
what are the causes of hypothyroidism?
A
- hashimoto’s disease
- iodine deficiency
- congenital
- pituitary tumour
- viral (e.g. subacute De Quervain’s thyroiditis)
- postpartum thyroiditis
- iatrogenic (e.g. amiodarone, lithium, sphenoid surgery, radiotherapy)
2
Q
what is hashimoto’s disease?
A
anti-thyroid peroxidase antibodies (anti-TPO) attack the thyroid gland, impairing the gland’s ability to produce thyroid hormones
3
Q
what are the risk factors for hypothyroidism?
A
- genetic
- pregnancy
- autoimmune (e.g. T1DM, coeliac disease, RA)
- previous thyroid surgery
- treatment with radioactive iodine
- radiation treatment to the head, neck or thorax
4
Q
what are the symptoms of hypothyroidism?
A
- weight gain
- constipation
- depression
- brittle hair
- brittle nails
- irregular, heavy periods
- loss of libido
- lethargy
- cold intolerance
5
Q
what are the signs on examination of hypothyroidism?
A
- dry skin
- bradycardia
- cold peripheries
- stiff muscles
- hair loss
- hertoghe’s sign (e.g. the loss of the outer third of the eyebrow)
6
Q
what are the investigations for hypothyroidism?
A
- TFTs
- autoantibody (e.g. anti-TPO)
- US
7
Q
what is the management of hypothyroidism?
A
- levothyroxine
- TFTs should be performed every three months to titrate the medications appropriately
- following a stable TSH level, thyroid function tests should be performed annually
8
Q
what are the long-term complications of hypothyroidism?
A
- myxoedema coma
- cardiac (e.g. CAD, HF)
- reproductive (e.g. sub-fertility, miscarriage, stillbirth, pre-eclampsia, postpartum haemorrhage)
9
Q
what is myxoedema coma?
A
a rare and potentially fatal complication of hypothyroidism presenting with:
- altered mental state
- hypothermia
- bradycardia
- hypoventilation
