Thyroid

Question 1

Primary vs secondary thyroid

Answer 1

Primary - gland (t3, T4)
Secondary - hypothalamus/pituitary

Question 2

Antibodies involved in Hashimoto thyroiditis

Answer 2

Antimicrosomal
Antithyroid peroxidase

Question 3

Antibodies involved in Graves disease

Answer 3

TSH receptor antibodies

Question 4

Most cost-effective investigation in the diagnosis of thyroid nodules for malignancy

Answer 4

FNAC

Question 5

Which thyroid nodule could be more malignant, functioning/non-functioning

Answer 5

Non-functioning/Cold nodule

Question 6

RAIU in graves, toxic nodule, thyroiditis, cold nodule

Answer 6

Functioning or non-functioning nodule differentiation

Increased uptake, diffuse - Graves
Increased uptake, one/multiple nodule - Toxic nodule

Dec uptake - Thyroiditis

No uptake - cold nodule

Question 7

Radio iodine therapy will cause hypo/hyperthyroidism?

Answer 7

Hypothyroidism

Question 8

Mcc of hypothyroidism

Answer 8

Hashimotos

Question 9

TSH and T3 T4 in secondary hypothyroidism, next best investigation

Answer 9

Secondary means abnormality in pituitary/hypothalamus (central)

TSH - N or low
T3, T4 - low

Next best inv - MRI brain for tumours

Question 10

Management of hypothyroidism

Answer 10

Thyroxine - 1.6 microgm/bodywt

Healthy elderly - 50 micrograms
Old, frail - 25/12.5 micrograms

Question 11

Pregnancy and thyroid

Answer 11

Check TSH levels in first trimester
Iodine - 150micrograms/day for all

Question 12

Mcc of b/l non-toxic goitre in Australia

Answer 12

Hashimotos thyroiditis
(hypo)
Anti-thyroid peroxidase antibody

Question 13

Mcc of hyperthyroidism

Answer 13

Post partum hyperthyroidism&raquo_space;
Graves disease

Question 14

Plummers disease

Answer 14

Toxic multinodular goitre
Arrhythmias
CHF

Question 15

Rx for hyperthyroidism in young, with small goitre, mild case

Answer 15

Propylthiouracil 200-600mg
or
Carbimazole

Question 16

Rx for hyperthyroidism in old, small goitre

Answer 16

Radio iodine therapy

Question 17

Rx for hyperthyroidism in pregnant

Answer 17

Propylthiouracil
Contraindicated - Carbimazole

Question 18

Rx for hyperthyroidism in large goitre, moderate-severe cases

Answer 18

1. Propylthiouracil until euthyroid
   then
2. Radio iodine ablation(I 131)/Surgery

Question 19

Subacute hyperthyroiditis C/F and Rx

Answer 19

Post viral infection
Fever
Pain over thyroid gland
Hyperthyroidism

Rx:
1. Soft food
2. Aspirin/Ibuprofen (analgesics)
3. Rest
Anti thyroid drugs not required

Question 20

Hyperparathyroidism effect on calcium

Answer 20

Hyper calcemia