Brainscape's Knowledge GenomeTM

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


See full index

Semester 2 MEH > L22: Thyroid disorders > Flashcards

L22: Thyroid disorders Flashcards

1
Q

What are the main functions of the thyroid hormones?

A

Control metabolism

Growth and development

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

What systems in the body are affected by thyroid disease?

A 
Almost all systems 
Affects energy
Weight
Temperature 
Heart rate
Nervous system 
GI system
Musculoskeletal 
Skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is release of thyroid hormones from the thyroid gland controlled?

A

TRH released from hypothalamus stimulates AP
TSH released from AP stimulates thyroid gland
T3/4 released from thyroid gland
↑ T3/4 act back on the AP and hypothalamus to inhibit further release –> negative feedback

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

What happens to the levels of hormones in an underactive thyroid?

A

Low T3/4
High TSH
Primary hypothyroidism

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

What happens to the levels of hormones with an overactive thyroid?

A

High T3/4
Low TSH
Primary hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What methods are used to view the thyroid gland?

A

Thyroid ultrasound
Radio isotope scans–> thyroid scintigraphy
–> Uses technetium 99m
Plain X-ray or CT scan

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

What are some of the different ectopic thyroid nodules?

A

Hot nodule–> englarged thyroid nodule but only on one side
Toxic multinodular goitre
Lingual thyroid

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

What is hypothyroid? What are the symptoms?

A

Low thyroid hormones
Myxeodema–> swollen eyes, thickened skin, deepened voice
Tiredness, weight gain, cold intolerance, changes in appearance, depression, psychosis, joint/muscle ache, dry hair/skin, constipation, puffy eyes

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

What are the signs of hypothyroidism?

A 
Peri-orbital oedema
Loss of eyebrows
Dry, thin hair
Bradycardia
Slow-relaxing reflexes
Carpal tunnel syndrome
Cold peripheries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the causes of hypothyroidism?

A 
Auto-immune atrophic
Hashimoto's thyroiditis (get Goitre)
Post partum thyroiditis
Dyshormonogenesis 
Medication 
Iodine deficiency --> can't produce thyroid hormone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is hypothyroidism treated?

A

Thyroxine replacement therapy –> Levothyroxine (T4)

  • -> For life
  • -> Starting dose depends on severity
  • -> 100 micrograms for young and fit person
  • -> More caution in elderly and heart disease–> could cause tachycardia–> trigger angina
  • -> Resolution takes 6-8 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the special situations in hypothyroidism to be aware of?

A

Myxoedema coma–> pt low temperature and low pulse

  • -> Severe hypothyroidism- usually elderly, usually rare
  • -> Hypothermia and fluid overload in heart- pericardial effusion
  • -> 50% mortality so it require high dependency treatment

Borderline or sub-clinical hypothyroidism

  • -> Low/normal T4 with very high TSH–> very common
  • -> Monitored until symptoms appear
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is hyperthyroidism? What are the symptoms?

A 
High thyroid levels--> overactive
Weight loss
Irritability
Restlessness
Insomnia
Malasise
Itching 
Sweating 
Palpitations
Tremor
Muscle ache
Diarrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the signs of hyperthyroidism?

A 
Tremor
Hyperkinesis--> muscles spasm
Tachycardia
Atrial fibrillation 
Warm peripheries 
Hypertension 
Proximal myopathy 
Lid Lag--> eye lids open wider
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the causes of hyperthyrodism?

A

Graves disease–> autoimmune disease
Nodular thyroid disease–> lumpy thyroid, secretes excess thyroid (not autoimmune)
Thyroiditis–> Inflammation, destructive release

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

What is Graves disease?

A

Most common hyperthyroidism
Autoimmune mediated stimulation of TSH receptor
By thyroid stimulating immunoglobulin (TSI)
High levels of T3,4, Low TSH

17
Q

What causes Graves opthalmopathy?

A

Autoimmune antibody’s target fibroblasts in the eye muscles
Fibroblast turn into adipocytes
Fat cells and muscles expand and become inflammed
Veins become compressed–> oedema
Optic nerve can become compressed/stretched as eye is pushed out–> blindness if not relieved

18
Q

What is Graves dermopathy?

A

aka pertibial myxoedema

Skin on anterior leg becomes red, itchy and thickened

19
Q

What is thyroid acropachy?

A

Acropachy–> thickening of extremities
Triad of things: digital clubbing, swelling of soft tissue in hands and feet, periosteal bone formation
Sign of thyrotoxicity –> over treatment with thyroid drugs or overactive thyroid

20
Q

What is nodular hyperthyroidism?

A

Single toxic nodule or multiple nodules

Single aka hot nodule

21
Q

What is thyroiditis? What causes it?

A 
Inflammation of thyroid 
Release of thyroxine into circulation
Viral infection--> de quervain's thyroiditis
After childbirth--> post partum 
Medication--> amiodarone
22
Q

How is hyperthyroidism treated?

A

Medication
Surgery
Radioactive iodine

23
Q

What medication is given to treat hyperthyroidism?

A

Carbimazole or propylthioutacil (thionamides)
Beware of agranulocytosis –> neutropenia –> supress immune system –> pt get rash or fever immediately stop medication and get FBC
Beta blockers–> control the symptoms –> block sympathetic function

24
Q

What is the surgical procedure done to treat hyperthyroidism?

A

Done if side effects to medication or patient preference
Removal of thyroid gland
Small risk of laryngeal nerve pasly and hypocalcaemia (damage to parathyroid gland)

25
Q

What is the radioactive treatment for iodine?

A

Good non surgical option
Contra-indicated in pregnancy
Mute thyroid gland–> radioactive iodine given
Must follow radiation restriction guidance after treatment

26
Q

What are the special situations in hyperthyroidism?

A

Thyroid crisis/ thyroid storm–> rare condition–> 10% mortality

  • -> Hyperpyrexia, tachycardia, cardiac failure, liver dysfunction
  • -> Need urgent treatment on high dependency unit

Hyperthyroidism and pregnancy

  • -> Graves disease- antibodies cross the placenta
  • -> Baby born with hyperthyroidism
  • -> Requires close monitoring in pregancy
27
Q

What is Goitre?

A

Means swelling of thyroid

7% female, 1% males

28
Q

What are the different types of goitre?

A 
Diffuse goitre
--> Simple
--> Autoimmune thyroid disease or Thyroiditis
Nodular goitre
--> Multinodular goitre
--> Solitary nodule--> Red Flag
Fibrotic goitre
--> Riedel's thyroiditis--> rare
--> Associated with midline fibrosis 
Iodine deficient 
--> Common worldwide
--> Rare in UK
29
Q

What are the red flag symptoms for thyroid cancer?

A 
History
--> Very young or old
--> Rapid enlargement of lump in neck
--> Hoarse voice an dysphagia
--> Family history of thyroid cancer
Examination
--> Hard irregular thyroid mass
--> Fixed to surrounding structures
--> Cervical lymph nodes
30
Q

How would investigate suspected thyroid cancer?

A

Thyroid ultrasound
Fine needle aspiration
CT scan thorax and mediastinum

31
Q

How would you treat suspected thyroid cancer?

A

Removal of thyroid
Surgery–> must be done by expert–> laryngeal nerve palsy, hypocalcaemia
Large tumour–> radioiodine ablation

Semester 2 MEH (23 decks)

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