Hypothyroidism Flashcards
What antibodies are present in hashimotos thyroiditis?
Anti TPO
Anti thyroglobulin
What kind of goitre do you get in hashimtos thyroiditis?
Firm, non tender goitre
What kind of goitre do you get due to an iodine deficiency?
Non toxic multinodular goitre
What type of hypersensitivity reaction os hashimotos thyroiditis?
Type IV
What cardiac drug can cause hypothyroidism?
Amioderone
What is the initial treatment for hypothyroidism?
Thyroxine 50 - 100ug daily
How much does thyroixine dose need to be increased in prganancy?
25 - 50%
What is the initial dose of thyroixine for an elderly person who also has a histrory of heart disease?
Thyroxine 25 - 50ug daily
What marker do you use to monitor response to treatment for primary hypothyroidism?
TSH
What marker do you use to monitor response to treatment for secondary hypothyroidism?
T4
What psychiatric drug can cause hypothyroidism?
Lithium
What two immunological drugs can cause hypothyroidism?
Alpha interferon
IL2
How do you treat a myexodema coma?
IV levothyroxine (If no response within 24 hrs start IV T3)
IV hydrocortisone
Treat precipitating factors eg infection with antibiotics
Replace IV fluids and glucose as necessary
Slow warming to correct hypothermia
What should you do if you are considering starting levothyroxine but you think the patient has adrenal insufficiency?
Short synacthen test
What can thyroxine cause in patients with adrenal insufficiency?
Addisonian crisis
What respiratory manifestation can you get with hypothyroidism?
Pleural effusion
What psychiatric complication can you get with hypothyroidism?
Dementia
What cardiovascular complications can you get with hypothyroidism?
Pericardial effusion
Bradycardia
Low volume pulse
What peripheral nervous system problems can you get with hypothyroidism?
Carpal tunnel syndrome
Proximal mypathy
Are cholesterol levels high or low in hypothyroidism?
High
Where abouts does hairloss occur in hypothyroidism?
lateral third of the eyebrow
What is sick euthyroid syndrome?
There is a low T3/T4 but the thyroid gland doesn’t appear to be disfunctional and there is a normal TSH
In what situations might you get sick euthyroid syndrome?
Intensive care
Starvation
