Throid Disease Flashcards
what is excess thyroid hormone known as?
hyperthyroidism
what is meant by PRIMARY endocrine disease?
gland failure
what is meant by SECONDARY endocrine disease?
control failure
what is a deficiency of thyroid hormone known as?
hypothyroidism (also myxoedema)
what disease causes majority of hyperthyroidism cases?
Graves’ disease
what is Graves’ disease?
- organ specific autoimmune disease
how does Graves’ disease cause hyperthyroidism?
- body produces an antibody that is similar to the TSH receptor
- antibody binds the TSH receptor on the thyroid gland
- TSH receptor thinks that TSH has bound
- stimulated thyroid gland to release more hormone
how can a toxic adenoma cause hyperthyroidism?
tumour within the thyroid gland over-produces the hormone in an unregulated way
what are the signs of hyperthyroidism?
- warm moist skin
- tachycardia & atrial fibrillation
- increased BP & heart failure
- tremor
- eyelid retraction and lid lag
what are symptoms a patient suffering from hyperthyroidism will experience?
- hot and excess sweating
- weigh loss
- diarrhoea
- palpitations
- irritable, manic, anxious
- muscle weakness
what are clinical signs that a patient is suffering with Graves’ disease?
- goitre (swelling of thyroid gland)
- proptosis (eyeballs pushed forward)
- periorbital oedema (swelling around eyes)
what may cause primary Hypothyroidism?
- Hashimoto’s disease (autoimmune thyroiditis)
- Idiopathic atrophy
- Radioiodine treatment/thyroidectomy surgery
- iodine deficiency
- drugs
- congenital
what occurs to a patient suffering from Hashimotos disease?
- body produces an antibody which attacks the thyroid gland
- causes inflammation of the gland
- gradual fibrosis and destruction of the specialised thyroid tissue
what is a secondary cause of Hypothyroidism?
hypothalamic/pituitary disease
what are the signs of hypothyroidism?
- dry coarse skin
- bradycardia, hyperlipidaemia
- psychiatric or confusion
- goitre (hashimotos)
- delayed reflexes
in a patient suffering with Hypothyroidism, what symptoms may they present with?
- tired
- cold intolerance
- weight gain
- constipation
- goitre and puffed face & extremities
- angina
- hair loss (eyebrows)
who is most likely to suffer from Hashimoto’s Thyroiditis?
middle aged & elderly women
what investigations may be carried out in a patient with suspected Thyroid Disease?
- blood tests
- imaging
- tissue biopsy
what blood tests may be undertaken when investigating thyroid disease?
looking at levels of:
- TSH (thyroid stimulating hormone)
- T3 and T4
what imaging tests may be done when investigating thyroid disease?
- ultrasound scan (cysts)
- radioisotope scans (gland uptake)
what type of tissue biopsies may be done when investigating Thyroid Disease?
- fine needle aspirate (FNA)
- fine needle biopsy (FNB)
explain the hormone levels (of TSH and T3/4) in a patient suffering with Hyperthyroidism caused by the pituitary:
- raised TSH
- raised T3
explain the hormone levels of a patient suffering with Hyperthyroidism caused by Graves’ disease or an adenoma?
- low TSH
- raised T3
explain the hormone levels of a patient suffering with Hypothyroidism caused by the pituitary:
- low TSH
- low T4
explain the hormone levels of a patient suffering with Hypothyroidism caused by gland failure (Hashimoto’s):
- high TSH
- low T4
what are the treatment options for a patient suffering from Hyperthyroidism?
- carbimazole
- beta blockers
- radioiodine
- surgery (partial thyroidectomy)
why might beta blockers be given to a patient suffering with Hyperthyroidism?
to reduce anxiety, tremors and palpitations
what are the treatment options for a patient suffering with Hypothyroidism?
give T4 tablets (thyroxine)
what may thyroid swelling be suggestive of?
thyroid cancer
in dentistry, if a patient is suffering from Hypothyroidism what may need to be avoided?
the use of sedatives if their hypothyroidism is severe
