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
