Primary Thyroid and Parathyroid Problems

Question 1

What are the hormone levels in hypothyroidism?

Answer 1

• Low T4/T3

- High TSH

Question 2

What is the main cause of hypothyroidism?

Answer 2

Hashimoto’s thyroiditis

Question 3

What antibodies are present in Hashimoto’s thyroiditis?

Answer 3

Anti-TPO

Question 4

What are main signs and symptoms of hypothyroidism?

Answer 4

• Weight gain
• Cold intolerance
• Low HR

Question 5

How do you diagnose hypothyroidism?

Answer 5

Bloods - low T4

Question 6

How do you treat hypothyroidism?

Answer 6

Levothyroxine (T4 replacement)

Question 7

What are the hormone levels in hyperthyroidism?

Answer 7

• High T4/T3

- Low TSH

Question 8

What is the main cause of hyperthyroidism and what antibody is present in this disease?

Answer 8

Graves’ disease (anti-TSH)

Question 9

What are main signs and symptoms of hyperthyroidism?

Answer 9

• Weight loss
• Heat intolerance
• Increased HR

Question 10

What are two specific signs of Graves’ disease?

Answer 10

• Eye protrusion

- Pretibial myxoedema

Question 11

How do you diagnose hyperthyroidism?

Answer 11

Bloods - high T4

Question 12

How do you treat hyperthyroidism?

Answer 12

• Carbimazole (CI in pregnancy) + propanolol (symptom release)
• Propylthiouracil instead of carbimazole - younger females, safer in pregnancy
• Second-line = radioactive iodine therapy (RAIT) - often need to take long term levothyroxine

Question 13

What is the main cause of hypoparathyroidism?

Answer 13

Autoimmune to PTH gland (anti-PTH and anti-CaSR)

Question 14

What does hypoparathyroidism lead to?

Answer 14

Hypocalcaemia

Question 15

What are main signs and symptoms of hypoparathyroidism?

Answer 15

Hypocalcaemia

• Muscle spasms
• Perioral paraesthesia
• Chvostek’s sign = twitching of muscles innervated by the facial nerve

Question 16

How do you diagnose hypoparathyroidism?

Answer 16

Bloods - low PTH, low Ca

Question 17

How do you treat hypoparathyroidism?

Answer 17

Calcitriol - Ca and vit D supplement

Question 18

What is the main cause of hyperparathyroidism?

Answer 18

PTH benign tumour (adenoma)

Question 19

What does hyperparathyroidism lead to?

Answer 19

Hypercalcaemia

Question 20

What are the main signs and symptoms of hyperparathyroidism?

Answer 20

Hypercalcaemia - bones, stones, groans and moans

• Osteoporosis (bone pain)
• Kidney stones
• Abdominal pain
• Depression/confusion

Question 21

How do you diagnose hyperparathyroidism?

Answer 21

Bloods - high PTH, high Ca

Question 22

How do you treat hyperparathyroidism?

Answer 22

Surgery

Question 23

What is the main cause of secondary hyperparathyroidism?

Answer 23

CKD - would have low calcium, treat with vitamin D analogue (paricalcitol)