Thyroid Flashcards
Hypothyroidism symptoms
Weight gain
Always cold
Constipated
Depressed
Always tired
Bradycardia
Goitre
Hypothyroidism causes and risk factors
Amiodarone
Lithium
Congenital condition (present from birth)
Other autoimmune disease
Thyroid surgery
Hypothyroidism complications
Fertility
Neurological ( memory deficits)
Contribute to CV problems ( HF, CHD, High cholesterol)
Myxodema
Caused by prolonged low metabolism
Bradycardia
Poor peripheral perfusion
Poor kidney perfusion
Hypoventilation
What is the diagnos of hypothyroidism
TFT test
TSH increased
T4 decreased (Hate)
Subclinical
TSH increased
T4 normal
Biopsy, scans
When would you REFER to endocrinologist
Goitre
Suspected addisons
Pregnancy/planning
Cardiac disease
Atypical thyroid tests
Drug causes - Amiodarone and lithium
Levothyroxine SE and ci/ cautions
Interactions - calcium/antacids/iron salts - take 4 hours apart
If have hyper symptoms (weight loss, insomnia, heat intolerance, diarreoah)
Contact endocrinologist for dose adjustment
Levothyroxine MOA
Binds to the thyroid hormone receptor to activate gene transcription
What are hyperthyroidism symptoms
Weight loss
Always hot
Diarrhoea
Anxious
Hyperactive
Insomnia
Tachycardia
Goitre
Hyperthyroidism causes and risk factors
Amiodarone
Lithium
Family history of Graves’ disease
Other autoimmune disease
Tumour on thyroid glands
What are complications of hyperthyroidism
Osteoporosis
Eye problems
Skin problems
Heart problems - congestive HF
Thyroid storm
Due to untreatment
Sudden severe excess of T4
Confusion
Agitation
Vomiting
Extreme tachycardia
Diagnosis of hyperthyroidism
TFT test
TSH decreased
T4 increased
Subclinical
TSH decreased
T4 normal
Treatment of hyperthyroidism
1st line Carbimazole
2nd propylthiouracil
Radioiodine
Surgery to remove gland
Carbimazole SERIOUS SE
STOP bone marrow suppression
SAME DAY BLOOD TESTS
REPORT signs of infection - sore throat, fever
STOP pancreatis
STOP jaundice
Pregnancy - speak to endocrinologist
PTU SERIOUS SE
STOP liver injury REFER to endocrinologist
MOA carbimazole
Inhibits oxidation of iodine to iodine
Inhibits organification of iodine to make tyrosine residues
Inhibits coupling of iodotyrosine
PTU/ propylthiouracil MOA
Same as carbimazole PLUS inhibits. 5-deiodinase, preventing T3 formation
