L20 - thyroid disorders

Question 1

What are thyrglossal cysts?

Answer 1

Thyroid remnants from embryology which didn’t fully descend

Question 2

You suspect an enlarged thyroid gland, you ask the patient to swallow and you see the lump move, is the thyroid gland involved?

Answer 2

Yes if it moves on swallowing then the thyroid is involved.

Question 3

Give three causes of hyperthyroidism and three causes of hypothyroidism

Answer 3

Hypothyroidism - Hashimoto’s/iodine deificency/anti-thyroid drugs/TSH defiicency/failure of thyroid gland

Hyperthyroidism - Grave’s disease/toxic multinodular goitre/thyroiditis (due to amiodarone or viral infection or post partum)/excess T3/T4 therapy/thyroid adenoma

Question 4

What is the treatment for hypothyroidism?

Answer 4

T4 replacment for life - note - takes 6-8 weeks to normalise levels

Question 5

What is the treatment for hyperthyroidism?

Answer 5

Carbimazole (blocks effects of thyroid peroxidase)/surgery if needed/iodine if iodine deficient

Question 6

What is thyroid storm?

Answer 6

an exaggeration of hyperthyroidism - hyperpyrexia, tachycardia, cardiac failure and liver dysfunction

Question 7

What does ‘derbyshire neck’ refer to?

Answer 7

A goitre called by iodine deficiency hypothyroidism