Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > Hypothyroidism + Thyroid Tumours > Flashcards

Hypothyroidism + Thyroid Tumours Flashcards

1
Q

What are the causes of hypothyroidism?

A

Hashimoto’s thyroiditis
Iodine deficiency
Secondary to any treatment for hyperthyroidism
Medications
Hypopituitarism (secondary hypothyroidism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which medications might cause hypothyroidism?

A

Lithium
- causes goitre + hypothyroidism
Amiodarone
- usually causes hypothyroidism, but can cause thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the clinical features of hypothyroidism?

A 
Weight gain
Fatigue
Dry skin
Coarse hair + hair loss
Fluid retention (oedema, pleural effusions, ascites)
Heavy/irregular periods
Constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What would blood tests show in primary + secondary hypothyroidism?

A 
Primary:
- T3 + T4 low
- TSH high
Secondary:
- T3 + T4 low
- TSH low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the treatment for hypothyroidism?

A

Levothyroxine

  • titrate until TSH levels normal
  • if TSH levels high, dose is too low
  • if TSH levels low, dose is too high
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is levothyroxine?

A

Synthetic T4, metabolises to T3 in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the features of Hashimoto’s thyroiditis?

A

Most common cause of hypothyroidism in developed world
Autoimmune
Anti-TPO + antithyroglobulin antibodies
Initially causes a goitre, but then atrophy of thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common cause of hypothyroidism in the developing world?

A

Iodine deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which advice should be given to patients regarding when to take their levothyroxine?

A

Take on an empty stomach, at least 30 mins before breakfast, caffeine or other drugs which might interfere with absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which drugs might impair absorption of levothyroxine?

A

Calcium carbonate
Antacids
Iron supplements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which patients might require a lower dose of levothyroxine initially?

A

Elderly + those with IHD –> risk of MI

start at low dose and build up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How should levothyroxine dose be altered during pregnancy?

A

Should be increased by 50% in the first trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the complications of hypothyroidism?

A

Myxoedema coma
If chronic:
- heart disease
- dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the complications of hypothyroidism during pregnancy?

A

Eclampsia
Anaemia
Prematurity
SGA baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is myxoedema come?

A

Severe, acute hypothyroidism –> 50% mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the clinical features of myxoedema coma?

A

Often follows illness (infection, stroke, seizure, surgery) or medication (sedatives):

  • hypothermia
  • neuro: reduced reflexes, seizures, coma
  • hypoglycaemia
  • bradycardia
17
Q

What is the treatment for myxoedema coma?

A

IV T3

Corticosteroids as Addison’s may be present, either as alternative diagnosis or co-morbid hypopituitarism

18
Q

What is sick euthyroid syndrome?

A

Abnormal TFTs during a non-thyroid illness

routine TFTs during illness is not recommended

19
Q

What are the different types of thyroid tumours?

A 
Benign:
- adenomas
Carcinomas:
- papillary
- follicular
- medullary
- anaplastic
20
Q

How are thyroid adenomas classified?

A 
Functioning:
- releases hormones
- 'hot' on radioisotope scan
Non-functioning:
- 'cold' on radioisotope scan
21
Q

What is the management of thyroid adenomas? Why?

A

Hemithyroidectomy + histological analysis

- most are follicular adenomas which cannot be distinguished from follicular carcinoma on FNA

22
Q

What is the most common thyroid cancer?

A

Papillary carcinoma

23
Q

What are the clinical features of papillary thyroid carcinoma?

A

Young patients
May spread to cervical lymph nodes
Excellent prognosis

24
Q

How is papillary thyroid carcinoma treated?

A

Hemithyroidectomy for histology
Followed by completion thyroidectomy (if >1cm)
Then radio iodine
(can do initial thyroidectomy if FNA cytology is definitive)

25
Q

What are the features of follicular thyroid carcinoma? How is it managed?

A

Also young patients
May metastasise e.g. to bone

Managed the same as papillary carcinomas

26
Q

What are the features of medullary thyroid carcinoma?

A

Tumour of C cells
Part of MEN 2
Raised calcitonin

27
Q

What are the features of anaplastic thyroid carcinoma and how is it managed?

A

Rare tumour seen in older patients
Rapid onset + spread
Poor prognosis

Palliative treatment
- may involve tracheostomy + external beam RT

28
Q

What are the complications of a thyroidectomy?

A

Recurrent laryngeal nerve injury:
- hoarse voice
- airway obstruction to to vocal cord closure if bilateral
Bleeding + haematoma –> acute airway obstruction
Hypoparathyroidism + low calcium
Hypothyroidism

Endocrine (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions