Learning Objectives Flashcards
Give an outline of how the hypothalamus and thyroid combine to secrete T3 and T4 hormones
What do T3 and T4 actually do?
What are the common clinical features of Hyperthyroidism?
What are the clinical features of Hypothyroidism?
What is Thyrotoxicosis? And how is it different from Hyper thyroidism?
What is the pathophysiology of Graves Disease?
Graves disease is an autoimmune disease characterized by hyperthyroidism due to circulating autoantibodies.
Thyroid-stimulating immunoglobulins (TSIs) bind to and activate thyrotropin receptors
This causes the thyroid gland to grow and the thyroid follicles to increase synthesis of thyroid hormone.
What the clinical features of Graves disease?
What are the other 3 most common causes of Hyperthyroidism apart from Graves?
Notes:
Toxic Multinodular Goitre
A toxic nodular goiter (TNG) is a thyroid gland that contains autonomously functioning thyroid nodules, with resulting hyperthyroidism.
De Quervain’s Thyroiditis
Causes damage to thyroid follicular cells, resulting in no new thyroid hormone production and excessive release of large amounts of triiodothyronine(T3) and thyroxine(T4).
HYPERTHYROIDISM CAN ALSO BE CAUSED BY A TSH-SECRETING PITUITARY ADENOMA
- Rare
- Secondary Hyperthyroidism
These excess hormones contribute to clinical and biochemical hyperthyroidism and inhibition of TSH (negative feedback).
With the release of the stored thyroid hormone and the absence of new thyroid hormone production, the phase of hyperthyroidism can last only for 2 to 8 weeks. During this early inflammatory state, the thyroid gland is mildly enlarged and is tender to palpate.
After the inflammation is subsided, new thyroid follicular cells are generated and resume thyroid hormone synthesis.
The patient then goes through a short phase of euthyroidism and hypothyroid before returning to normal thyroid function.
What is a thyroid storm?
Clinical Signs are generally an enhanced version of the normal hyperthyroid symptoms
- Pyrexia
- Tachycardia
- Delirium
- Arrhythmias
- High-Output Cardiac Failure
- Seizures/Coma
What are the 4 main causes of Hypothyroidism?
Give an outline of Hashimoto’s Thyroiditis
What does Iatrogenic mean?
Relating to illness caused by medical examination or treatment.
What are the other 3 most common causes of Hyperthyroidism apart from Graves?
NOTE: De Quervain’s can also cause Hypothyroidism after the initial Hyperthyroid phase, sometimes just the hypo phase occurs
What is the bRADYCARDIC acronym for hypothyroidism symptoms?
What is a Myxoedema Coma?
How do you interpret TFTs in terms of determining if it’s Primary/Secondary Hyper/Hypo Thyroidism?
Opposite Directions: Primary
Same Direction: Secondary
NOTE:
Subclinical = Relating to or denoting a disease which is not severe enough to present definite or readily observable symptoms.
Which two antibody tests are common to order for thyroid disease, and which conditions does each suggest?
Why can the use of ultrasound be useful in diagnosis certain thyroid conditions?
What are isotope scans used for?
How do Graves, TMG, Adenoma and Carcinoma appear on an isotope scan?
Graves: Diffuse high uptake of isotopes
TMG/Adenoma: ‘Hot Nodules’ - Concentrated spots of high uptake
Carcinoma: ‘Cold’ areas of unusually low uptake
Outline the usage and function of Carbimazole/Propylthiouracil
Outline the usage and function of Radioactive Iodine
Give an overview of the surgical options for hyperthyroidism
Outline the usage and function of Carbimazole/Propylthiouracil
What is the main treatment for hypothyroidism?
What does FNAC mean?
What are 6 common types of neck lump? And how do they appear
