hypothyroisism Flashcards
autoimmune condition usually seen in women over 60?
hashimotos
hashimotos associated with high titres of auto antibodies. which auto antibodies ?
TRAB blocking
anti thyroid peroxidase
anti thyroglobulin
other causes of hypothyroidism?
atrophic thyroiditis
iodine deficiency
iatrogenic
two goitrous causes of hypothyroidism?
hashimotos, iodine deficiency
non goitrous causes ?
ablation, atrophic thyroidits, congenital
iatrogenic causes of hypothyroidism?
post thyroidectomy, post radiotherapy to thyroid,
drugs - Lithium, Amiodarone
SYMPTOMS - GI
contipation
GU?
menorrhagia, infertility
MSK
weakness, cramps, myalgia
psychiatric ?
depression, reduced memory, dementia
general?
weight gain, tiredness, fatigue, peri orbital swelling
derm
dry skin, course hair, hair loss, so of outer third of eyebrow
neurology?
ataxia - slow, relxing reflexes
general?
cold peripheries, facial puffiness, non pitting oedema on hands and feet
low T3?T4, high TSH?
primary
low TSH, low T3/T4?
secondary
subclinical hypo?
high TSH, normal T3/T4
management of hypo?
levothyroxine
what is levothyroxine?
T4
difference in doses between younger and older patients?
elderly get half the dose
what do you need to monitor when on levothyroxine?
TSH
what is myxoedema coma
ultimate state of hypothyroidism before death
management of myxoedema coma?
TFT/baseline bloods correct hypoglycaemia actively warm patient give T3 infusion give hydrocortisone
when would you get myxoedema coma and how would you treat it?
MI
infection
untreated hypothyroid
post pituitary surger
