Thyroid Flashcards
A patient has a tremor, talks quickly, is anxious, sweaty, can’t sleep, has an increased appetite and has had unexplained weight loss. Is it more likely to be hyper or hypo thyroidism
Hyperthyroidism
How may the heart rate be affected in hyperthyroidism?
May be tachycardia
What may the hair be like of a person with hyperthroidism?
fine and brittle
After inspecting the patient’s general appearance, what is the first thing you would examine?
hands
What things are we looking for when we examine the hands?
temperature, sweating, palmar erythema, clubbing, brittle nails, oncholysis
What should we place on the dorsum of outstretched hands to amplify any fine tremor?
a piece of paper
What do we inspect the forearm for?
muscle wasting
How do you test for lid lag?
ask the patient to look up then down
What is exopthalmos associated with?
Grave’s disease
In a thyroid exam what should we palpate?
the trachea
anterior neck
cervical lymph nodes
When palpating the thyroid gland, what should you ask the patient to do?
swallow some water
Stick out their tongue
Which reflexes should you check in a thyroid exam?
ankle
How do we check for proximal muscle weakness?
ask patient to rise from chair while arms folded
What type of thyroidism is Grave’s disease?
hyperthyroidism
Is Grave’s disease autoimmune?
yes
What would you call a benign tumour of the thyroid gland that is making excess thyroid hormone?
thyroid adenoma
What would the blood tests for someone with primary hyperthyroidism show?
Low TSH
High T3
High T4
In what type of hyperthyroidism are TSH levels high?
secondary hyperthyroidism
What hormone is released from the anterior pituitary to stimulate the thyroid gland?
TSH
What effect does T3 have on basal metabolic rate?
speeds it up
Describe levels of TSH in primary hypothyroidism
Increased to try to compensate for low thyroid hormones
What is the most common cause of hypothyroidism in the UK?
Hashimoto’s thyroiditis
Is hashimoto’s thyroiditis autoimmune?
yes
What causes secondary hypothyroidism?
pituitary does not produce enough TSH
A patient complains of lethargy, cold sensitivity, brain fog, weight gain, a slow heart rate and constipation. Which type of thyroidism is it likely to be?
hypothyroidism
What is goiter?
an enlarged thyroid gland
What happens to the size of the thyroid gland in Hashimoto thyroiditis?
Size increases
