Hypothyroidism Flashcards
Define hypothyroidism.
Hypothyroidism is a clinical state resulting from underproduction of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). Most cases (95%) are due to primary hypothyroidism, a failure of the thyroid gland to produce thyroid hormones.
Explain the aetiology/risk factors of hypothyroidism.
Iodine deficiency
Family history of autoimmune thyroiditis
Autoimmune disorders
Graves’ disease
Post-partum thyroiditis
Turner’s and Down’s syndromes
Primary pulmonary hypertension
Multiple sclerosis
Radiotherapy
Amiodarone use
Lithium use
Summarise the epidemiology of hypothyroidism.
The incidence of primary hypothyroidism in the UK is estimated to be 0.41% per year for women and 0.06% per year in men. It is more common in middle aged women.
Recognise the presenting symptoms of hypothyroidism. Recognise the signs of hypothyroidism on physical examination.
Weakness
Lethargy
Cold sensitivity
Constipation
Weight gain
Depression
Menstrual irregularity
Myalgia
Dry or coarse skin
Eyelid oedema
Thick tongue
Bradycardia
Deep voice
Goitre
Identify appropriate investigations for hypothyroidism and interpret the results.
Serum thyroid-stimulating hormone (TSH)
Free serum T4
Serum cholesterol
FBC
Fasting blood glucose
Generate a management plan for hypothyroidism.
Levothyroxine
Identify the possible complications of hypothyroidism and its management.
Angina
Resistant hypothyroidism
Atrial fibrillation
Osteoporosis
Myxoedema coma
Complications in pregnancy
Summarise the prognosis for patients with hypothyroidism.
Prognosis is generally excellent with full recovery upon adequate replacement of thyroid hormones. The levothyroxine replacement dose may change over a period of years as the disease progresses or other conditions affecting thyroid hormone metabolism develop, but achieving excellent control of the disease is generally easily accomplished.
