Thyroid

Question 1

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

Answer 1

Hyperthyroidism

Question 2

How may the heart rate be affected in hyperthyroidism?

Answer 2

May be tachycardia

Question 3

What may the hair be like of a person with hyperthroidism?

Answer 3

fine and brittle

Question 4

After inspecting the patient’s general appearance, what is the first thing you would examine?

Answer 4

hands

Question 5

What things are we looking for when we examine the hands?

Answer 5

temperature, sweating, palmar erythema, clubbing, brittle nails, oncholysis

Question 6

What should we place on the dorsum of outstretched hands to amplify any fine tremor?

Answer 6

a piece of paper

Question 7

What do we inspect the forearm for?

Answer 7

muscle wasting

Question 8

How do you test for lid lag?

Answer 8

ask the patient to look up then down

Question 9

What is exopthalmos associated with?

Answer 9

Grave’s disease

Question 10

In a thyroid exam what should we palpate?

Answer 10

the trachea
anterior neck
cervical lymph nodes

Question 11

When palpating the thyroid gland, what should you ask the patient to do?

Answer 11

swallow some water

Stick out their tongue

Question 12

Which reflexes should you check in a thyroid exam?

Answer 12

ankle

Question 13

How do we check for proximal muscle weakness?

Answer 13

ask patient to rise from chair while arms folded

Question 14

What type of thyroidism is Grave’s disease?

Answer 14

hyperthyroidism

Question 15

Is Grave’s disease autoimmune?

Answer 15

yes

Question 16

What would you call a benign tumour of the thyroid gland that is making excess thyroid hormone?

Answer 16

thyroid adenoma

Question 17

What would the blood tests for someone with primary hyperthyroidism show?

Answer 17

Low TSH
High T3
High T4

Question 18

In what type of hyperthyroidism are TSH levels high?

Answer 18

secondary hyperthyroidism

Question 19

What hormone is released from the anterior pituitary to stimulate the thyroid gland?

Answer 19

TSH

Question 20

What effect does T3 have on basal metabolic rate?

Answer 20

speeds it up

Question 21

Describe levels of TSH in primary hypothyroidism

Answer 21

Increased to try to compensate for low thyroid hormones

Question 22

What is the most common cause of hypothyroidism in the UK?

Answer 22

Hashimoto’s thyroiditis

Question 23

Is hashimoto’s thyroiditis autoimmune?

Answer 23

yes

Question 24

What causes secondary hypothyroidism?

Answer 24

pituitary does not produce enough TSH

Question 25

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?

Answer 25

hypothyroidism

Question 26

What is goiter?

Answer 26

an enlarged thyroid gland

Question 27

What happens to the size of the thyroid gland in Hashimoto thyroiditis?

Answer 27

Size increases