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Endocrine > Thyroid 1 > Flashcards

Thyroid 1 Flashcards

1
Q

Screening blood test if thyroid problems are suspected

A

TSH

*if abnormal, then do T3 and T4

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2
Q

Blood results in primary hypothyroidism (TSH and T3/T4)

A
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3
Q

Blood results (TSH and T3/T4) in secondary hypothyroidism

A
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4
Q

Blood results (TSH and T3/T4) in hyperthyroidism

A
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5
Q

Antibodies that are usually present in Grave’s and Hashimoto’s

A
  • Antithyroid Peroxidase (anti-TPO) Antibodies - antibodies against the thyroid gland itself
  • most relevant thyroid autoantibody in autoimmune thyroid disease
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6
Q

Antithyroglobulin Antibodies

A
  • antibodies against thyroglobulin - a protein produced and extensively present in the thyroid gland
  • limited use - can be present in normal individuals
  • usually present in Grave’s Disease, Hashimoto’s Thyroiditis and thyroid cancer
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7
Q

Antibodies measured specifically in Grave’s disease

A
  • TSH Receptor Antibodies - autoantibodies that mimic TSH
  • bind to the TSH receptor and stimulate thyroid hormone release
  • They are the cause of Grave’s Disease
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8
Q

What is ultrasound imaging used for in thyroid?

A
  • diagnosing thyroid nodules
  • distinguishing between cystic (fluid filled) and solid nodules
  • Ultrasound can also be used to guide biopsy of a thyroid lesion
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9
Q

Investigation of what (2) thyroid conditions is radioisotope scan used in?

A
  • hyperthyroidism
  • thyroid cancer
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10
Q

Principle behind radioisotope scan of the thyroid

A
  • Radioactive iodine is given orally or intravenously
  • it travels to the thyroid where it is taken up by the cells. Iodine is normally used by thyroid cells to produce thyroid hormones
  • the more active the thyroid cells, the faster the radioactive iodine is taken up
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11
Q

Principles behind a gamma camera use in thyroid disease

A
  • A gamma camera is used to detect gamma rays emitted from the radioactive iodine
  • The more gamma rays that are emitted from an area the more radioactive iodine has been taken up
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12
Q

Gamma camera results. What diseases are they:

A. DIffuse high uptake

B. Focal high uptake

C. Cold areas

A
  • Diffuse high uptake is found in Grave’s Disease
  • Focal high uptake is found in toxic multinodular goitre and adenomas
  • “Cold” areas (i.e. abnormally low uptake) can indicate thyroid cancer
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13
Q

Meaning of:

A. Hyperthyroidism

B. Thyrotoxicosis

A

A. Hyperthyroidism: overproduction of thyroid hormone by the thyroid gland

B. Thyrotoxicosis: abnormal and excessive quantity of thyroid hormone in the body

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14
Q

Difference between a) primary b) secondary hyperthyroidism

A

a) primary hyperthyroidism -> thyroid gland itself behaves abnormally and produces excessive thyroid hormone
b) secondary hyperthyroidism -> thyroid gland produces excessive hormones as a result of overstimulation by TSH (pathology in hypothalamus or pituitary)

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15
Q

What’s pathophysiology of Grave’s disease

A

Autoimmune process -> TSH receptor antibodies are produced -> stimulation of thyroid gland to produce hormones

*TSH receptor antibodies mimic TSH

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16
Q

Another name for Toxic Multinodular Goitre

A

Toxic mutinodular goitre = Plummer’s disease

17
Q

What happens in toxic nodular goitre? (pathophysiology)

A

nodules develop on the thyroid gland -> they act independently of a normal feedback system -> excessive thyroid hormone production

18
Q

Which disease is exophthalmos seen in?

A

Grave’s

*inflammation, swelling and hypertrophy of a tissue behind eye -> exophthalmos

19
Q

Pathophysiology of pretibial myxedema

A
  • deposits of mucin
  • under the skin of anterior tibia
  • waxy discolouration, oedematous appearance
  • seen in Grave’s disease (reaction to TSH receptor antibodies)
20
Q

General symptoms of hyperthyroidism

A
  • Anxiety and irritability
  • Sweating and heat intolerance
  • Tachycardia
  • Weight loss
  • Fatigue
  • Frequent loose stools
  • Sexual dysfunction
21
Q

Unique features of Grave’s

A

These features all relate to the presence of TSH receptor antibodies:

  • Diffuse Goitre (without nodules)
  • Graves Eye Disease
  • Bilateral Exopthalmos
  • Pretibial Myxoedema
22
Q

Unique features (3) of Toxic Multinodular Goitre

A
  • Goitre with firm nodules
  • Most patients are aged over 50
  • Second most common cause of thyrotoxicosis (after Grave’s)
23
Q

Solitary Toxic nodule

  • what type of thyroid abnormality it would cause?
  • pathophysiology
  • management
A
  • hyperthyroidism
  • single abnormal thyroid nodule -> release thyroid hormone

Cause: thyroid benign adenoma

Management: surgical removal of the nodule

24
Q

De Quervain’s thyroiditis

  • features
A

Features: Presentation of viral infection (fever, neck pain, dysphagia) + features of hyperthyroidism

25
Q

Progression of De Quervain’s Thyroiditis (stages)

A

Hyperthyroid phase follows by hypothyroidism (due to TSH fall due to negative feedback)

Endocrine (11 decks)

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