Brainscape's Knowledge GenomeTM

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


See full index

Case 7 Thyroid Disease > Revision > Flashcards

Revision Flashcards

1
Q

What is thyrotoxicosis?

A

A constellation of clinical features arising from elevated circulating levels of thyroid hormone

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

What are the symptoms and signs of thyrotoxicosis?

A

Weight loss with a normal or increased appetite, heat intolerance, palpitations, tremor and irritability.

Tachycardia, palmar erythema, lid lag, tremor, warm/sweaty, goitre, bruit, agitation, onycholysis, Acropachy, Conjunctival oedema, Ophthalmoplegia, Pretibial myxoedema, Proximal myopathy, Hyperreflexia

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

What would you expect to see on blood tests in primary + secondary hyperthyroidism?

A

Primary - elevated free T4, elevated free T3, low TSH

Secondary - elevated free T4, elevated free T3, elevated TSH

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

What is the 1st line treatment (2) for thyrotoxicosis and for how long?

A

Carbimazole. Treat for 18 months - 24 months. Propanolol as well!!

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

What is the main side effect of carbimazole?

A

Neutropenia and Agranulocytosis.

Other SEs include rash, itching, nausea, vomiting

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

What is Graves’ Disease?

A

It is the commonest cause of hyperthyroidism and it is due to an autoimmune process resulting in the production of stimulating antibodies (Thyroid stimulating immunoglobulin [TSI]) to the thyroid TSH receptor.

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

What are other treatment options for hyperthyroidism?

A

Propylthiouracil 150mg, TDS. PTU is safer in pregnancy!

Radio-iodine

Surgery - sub-total thyroidectomy

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

What is the risk of thyroid surgery?

A

Damage to the recurrent laryngeal nerve.

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

What are precautions with radio-iodine?

A

No pregnancy for 6 months

Restrictions on contact up to 3 weeks

May worsen eye disease

Hypothyroidism is inevitable and will require lifelong levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does radioactive iodine work?

A

It is rapidly taken up by the thyroid gland. There the release of radiation destroys the tissue over a period of 6-18 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is hypothyroidism?

A

The clinical effect of lack of thyroid hormone. This can be due to lack of production by the thyroid gland or lack of stimulation by hypothalamus-pituitary axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the symptoms of hypothyroid?

A

Tiredness, sleepy, lethargic; decreased mood; cold-disliking; increased weight; constipation; menorrhagia; hoarse voice; memory/cognition; dementia; myalgia; cramps; weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the signs of hypothyroidism?

A

bradycardia, reflexes relax slowly, ataxia, dry thin hair/skin, yawning/drowsy/coma, cold hands ± decreased temp, ascites ± non-pitting oedema, round puffy face/double chin/obese; defeated demeanour; immobile ± ileus, CCF. Also neuropathy, myopathy, goitre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is hypothyroidism diagnosed?

A

Primary - Raised TSH, low T4

Secondary - low TSH, Low T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What the complications of hypothyroidism?

A

Increased risk of CVD disease because of increased cholesterol production by the liver

Pregnancy complications

Myxodema coma

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

What would blood tests show in a poorly compliant patient with hypothyroidism?

A

normal T4, High TSH

17
Q

Said is a 32-year-old male who has recently emigrated to the UK from Nepal. He attends his GP practice with regards to symptoms of weight gain, tiredness and hoarseness of voice. Following blood tests, including a thyroid function test, it is found that he has hypothyroidism. What is the most likely cause of hypothyroidism in this patient?

A

Iodine Deficiency

18
Q

What is the most common cause of hypothyroidism in the developed world?

A

Hashimoto’s Thyroiditis

19
Q

How is secondary hypothyroidism investigated for?

A

MRI pituitary gland

20
Q

What are the clinical features of Subacute (De Quervain’s) thyroiditis?

A

goitre, hyperthyroidism and raised ESR and globally reduced uptake on technetium thyroid scan

21
Q

What hormone to medullary type thyroid cancer secrete?

A

Calcitonin

22
Q

What is the most common thyroid cancer?

A

Papillary

23
Q

What are the signs of hashimoto’s?

A

Hypothyroidism, firm non-tender goitre, anti-TPO antibodies

24
Q

Which disease is associated with auto-immune thyroid disease?

A

Myasthenia Gravis

25
Q

What would TFTs show in subclinical hypothyroidism?

A

High TSH, normal T4

26
Q

What is sick euthyroid?

A

Thyroid allostasis in critical illness. Common in hospital inpatients. Changes are reversible upon recovery from the systemic illness and no treatment is usually needed.

27
Q

What would TFTs show in sick euthyroid?

A

Low/normal TSH, Low T4, Low T3

28
Q

What is the most common cause of thyrotoxicosis?

A

Graves’ Disease

29
Q

What are specific features of Graves’ Disease?

A

Eye Disease (ophthalmoplegia, exophthalmos), thyroid acropachy, pre-tibial myxoedema

Case 7 Thyroid Disease (1 decks)

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