Hypothyroidism

Question 1

Define hypothyroidism

Answer 1

this is defined as an underachieve thyroid gland leading to deficiency of thyroid hormones

Question 2

define Myxoedema

Answer 2

when hypothyroidism becomes symptomatic

Question 3

What are the key things that hypothyroidism causes

Answer 3

1. Cold intolerance
2. Have a low metabolism
3. decreased cognitive function

Question 4

What are some of the features of hypothyroidism

Answer 4

1. Peaches and cream complexion
2. Loss of outer 1/3 of the eyebrow
3. Bradycaria
4. neuropathy and myopathy
5. costipation
6. Slow relaxation on reflexes

Question 5

What are the features of myxodema

Answer 5

in severe hypothyroidism you get swelling of the subcutaneous tissues = bunch of banana hands

Question 6

What are some of the key causes of hypothyroidism

Answer 6

In developing countries = iodine deficienc

in developed countries - hashimotos thryoditis

also

• ineffective (subacute thyroiditis - chronic is de quirvans)
• post thyroidectomy
• Drugs (amiodarone, lithium)
• Tumour

Question 7

What are some of the secondary causes of hypothyroidism

Answer 7

• Hypopituitism

- Hypothalamic disorders

Question 8

Investigations in hypothyroidism

Answer 8

Bloods:

• FBC
• TFTs
• TPO antibodies (increased in hashimotos)
• LFTs (can be raised)
• CK (raised due to myopathy)

Question 9

How is hypothyroidism diagnosed

Answer 9

TFTs (have a very low threshold for doing these as complications include heart disease and dementia)

Question 10

in what forms of hypothyroidism do you get a goitre and do you not get a goitre

Answer 10

Goitre:
- Hashimotos

No Goitre
- Autoimune

Question 11

Treatment of hypothyroidism

Answer 11

young: lifetime treatment with levothyroxine 500mg daily (dose changes at 6 weeks)

Elderly: start on 25mg of levothyroxine and increase at 25mg intervals

you want to normalise but not surprise TSH so aim for >0.5