Management of Thyroid I Flashcards
What does thyroid gland do?
- Stores large amount inactive hormones in extra-cellular follicles
- Produce T4 (thyroxine)/ T3 (tri-iodonthryronine)
- Produce calcitonin - regulate blood calcium levels
How is the thyroid gland regulated?
Hypothalmic pituitary axis
Hypothalamus secrete TRH, pituitary secrete TSH
Causes hypothyroidism?
Primary failure thyroid gland
Secondary failure - pituitary or hypothalamus
Iodine deficiency
What would you expect to see in primary failure of the thyroid?
Decrease T3/T4 and increased TSH
Goitre
What would you expect to see in secondary failure - pituitary or hypothalamic disorder?
Decrease TSH - decrease T3/T4
No goitre
What would you expect to see with iodine deficiency?
Decreased T3/T4 - increased TSH
Goitre
Clinical features of hypothyroidism
Decrease T3/T4 cause decreased metabolism
Weight gain, lethargy, bradycardia, cold intolerance, constipation
How would you investigate and manage hypothyroidism?
Thyroid function test
Tx = levothyroxine
Dental complications of hypothyroidism?
Delayed eruption, enamel hypoplasia, microganathia, macroglossia
Cause hyperthyroidism?
Abnormal thyroid
Secondary - hypothalamic or pituitary tumour
Tumour
What would you expect to see w/ abnormal thyroid in hyperthyroidism?
Example Graves
Increase T3/T4 decreased TSH
Goitre
What would you expect to see in pituitary/ hypothalamic dysfunction in hyperthyroidism?
Increase T3/T4 and increased TSH
Goitre
What would you expect to see in tumour?
Increased T3/T4 decreased TSH
No goitre
Clinical features of hyperthyroidism?
Weight loss, heat intolerance, irritability, sweating, tachycardia, moist skin, muscle weakness
What kind of thyroid condition is Graves?
Hyperthyroidism
Clinical features of Graves
Diffuse goitre
Eye sign - grittiness/ dryness/ muscle wasting/ pretibial myxoedema
How would you investigate hyperthyroidism?
TSH receptor antibodies
Thyrogolobulin abs
Thyroid radiosotrope scan
Tx hyperthyroidism?
Medication, surgery, radioactive iodine
Dental complication hyperthyroidism?
Accelerated eruption, increase susceptibility caries, periodontal disease
Sensitive epinephrine - cause palpitations
