THYROID

Question 1

What do high T3 levels cause?

Answer 1

Increased metabolism + potentiation of effects of catecholamines.

Results in weight loss and excessive sympathetic output.

Question 2

What do Loe T3 levels cause?

Answer 2

Weight gain, low mood, constipation, poor memory, hyporeflexia.

Question 3

General signs of hyperthyroidism?

Answer 3

Weight loss
Anxiety/ hyperactivity
Heat intolerance
Hoarse voice

Question 4

General signs of hypothyroidism?

Answer 4

Weight gain
Low mood
Cold intolerance

Question 5

What is thyroid acropachy?

Answer 5

Periosteal phalangeal bone overgrowth.

**Similar appearance to clubbing.

Question 6

What might thyroid acropachy suggest?

Answer 6

Graves’ disease.

Question 7

Onycholysis is associated with what?

Answer 7

Hyperthyroidism.

**This is detachment of nail from nail bed.

Question 8

Palmar erythema is associated with what?

Answer 8

Hyperthyroidism.

Question 9

What type of tremor is associated with hyperthyroidism?

Answer 9

Fine tremor.

Question 10

Heart rate abnormality associated with hypothyroidism?

Answer 10

Bradycardia

Question 11

Heart rate abnormality associated with hyperthyroidism?

Answer 11

Tachycardia/ AF

Question 12

Facial signs associated with hypothyroidism?

Answer 12

Dry skin
Thin hair/ hair loss
Outer third eyebrow loss

Question 13

Facial signs associated with hyperthyroidism?

Answer 13

Excessive sweating.

Question 14

5 eye signs that can be associated with Graves’ disease?

Answer 14

Lid retraction
Exophthalmos
Lid lag
Ophthalmoplegia/ diplopia
Eye inflammation

Question 15

Most common ocular sign of Graves’ disease?

Answer 15

Lid retraction.

Question 16

Cause of lid retraction?

Answer 16

Sympathetic hyperactivity causing excessive contraction of the superior tarsal and elevator palpebral superiors muscles.

Question 17

Cause of exophthalmos?

Answer 17

Oedema and lymphocytic infiltration of orbital fat, connective tissue and extra ocular muscles.

Question 18

Cause of eye inflammation?

Answer 18

Secondary to lid retraction + exophthalmos making the eye more prone to dryness.

Question 19

Cause of ophthalmoplegia/ diplopia?

Answer 19

Lymphocytic infiltration of orbital fat, connective tissue and extra ocular muscles.

Question 20

Cause of lid lag?

Answer 20

Secondary to lid retraction + exophthalmos.

Question 21

Thyroid problems that move upwards with swallowing?

Answer 21

Goitres + thyroglossal cysts.

Question 22

Thyroid problems that do not move upon swallowing?

Answer 22

Invasive thyroid malignancy

Lymph nodes

Question 23

Thyroid problems that move upwards on tongue protrusion?

Answer 23

Thyroglossal cysts.

Question 24

Thyroid problems that do not move with tongue protrusion?

Answer 24

Goitres and lymph nodes.

Question 25

Which characteristics of the thyroid gland do you need to assess for when palpating?

Answer 25

``` Size Symmetry Consistency Masses Palpable thrills ```

Question 26

Cause of thyroglossal cysts?

Answer 26

Persistence of the thyroglossal duct after birth.

Question 27

Why do thyroglossal cysts move upwards on tongue protrusion?

Answer 27

Because the tongue is attached to the thyroglossal duct when the thyroglossal cysts sit.

Question 28

3 types of goitre?

Answer 28

Diffuse (hyperplasia) Uninodular (single thyroid nodule) Multinodular (toxic multi nodular goitre)