Thyroid Flashcards
What is primary and secondary hypothyroidism
Primary - failure of the thyroid gland to produce thyroid hormones
Secondary - underproduction of the TSH by pituitary gland
What is the difference between overt and subclinical
Overt may be symptomatic
TSH increased
T4 decreased
Subclinical
Usually asymptomatic
TSH increased
T4 normal
Symptoms of hypothyroidism
Weight gain
Always cold
Constipated
Depressed
Always tired
Sleeps a lot
Bradycardia
Goitre
Cause and risk factors of hypothyroidism
Amiodarone
Lithium
Congenital condition (present from birth)
Other auto immune disease
Thyroid surgery
Complications of hypothyroidism
Fertility (harder to get/keep pregnancy)
Neurological problems (memory deficits)
Contribute to CV problems (CHD, HF, High cholesterol)
Myxodema cause and symptoms
Caused by prolonged low metabolism
Bradycardia
Poor peripheral perfusion
Poor kidney perfusion
Hypoventilation
Diagnosis of hypothyroidism
TFT test
TSH increase
T4 decreased
Subclinical
TSH increased
T4 normal
Biopsy and scans
What is the treatment
Levothyroxine
When would you refer to endocrinologist
Suspected Addison’s disease
Goitre
Pregnant/planning
Cardiac disease
Atypical thyroid tests
Drug causes lithium and amiodarone
Levothyroxine MOA
Binds to the thyroid hormone receptor to active gene transcription
Hyperthyroidism symptoms
Weight loss
Always hot
Diarrhoea
Anxious
Hyperactive
Insomnia
Tachycardia
Goitre
Cause and risk factors of hyperthyroidism
Amiodarone
Lithium
Family history of Graves’ disease
Other autoimmune diseases
Tumours on thyroid gland
Complications of hyperthyroidism
Osteoporosis
Eye problems
Skin problems
Heart problems - congestive heart failure
Thyroid storm cause and symptoms
Due to untreatment, treatment relapse
Sudden and severe excess of T4 leading to huge increase in metabolism
Confusion
Agitation
Vomiting
Extreme tachycardia
Hyperthyroidism diagnosis
Overt
TSH decreased
T4 increased
Subclinical
TSH decreased
T4 normal
