Thyroid Flashcards

1
Q

Thyroid hormones

A

the amount of circulating thyroid hormone is regulated by a negative feedback loop

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2
Q

High levels of T3 and T4,

A

Suppress the function and production of TSH or TRH- thyrotropin -releasing hormone produced by the hypothalamus = inhibit their own production

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3
Q

Hyperthyroidism:

A

High t3 and t4 and low tsh

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4
Q

Hyperthyroidism - Signs and symptoms include:

A
  • Increased metabolism and activity
    • Hyperactivity
    • insomnia
    • Heat intolerance
    • Increased appetite
    • Weight loss
    • Diarrhoea
    • Goitre
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5
Q

Treatment - first line for hyperthyroidism

A

Carbimazole

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6
Q

Carbimazole- MHRA Guidance

A
  • Neutropenia and agranulocytosis - report sore throat,malaise,fever
    • Congenital malformations - women use contraception during treatment
    • Acute pancretitis - report and stop immediately if develops signs
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7
Q

Propylthiouracil

A

patients should be cautious of liver disorder - jaundice,dark urine,nausea
Beta- blockers can be used to help with symptom relief

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8
Q

Graves’ disease - Radioactive iodine
Carbon and blocks of Lego

A
  • If remission likely to be achieved with an anti- thyroids, can consider consider carbimazole
    • Use carbimazole if iodine or surgery in not suitable
    • Given as a block and replace regimen in combo with levothyroxine for 12-18 months
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9
Q

Pregnancy

A
  • 1st trimester - propylthiouracil(due to carbimazole’s congenital defects)
    • 2nd and 3rd trimester - carbimazole (due to propylthiouracil’s hepatoxicity)
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10
Q

Hypothyroidism:

A

Low T3 +T4 HIGH TSH

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11
Q

Hypothyroidism se

A

Decreased metabolism and activity
- Fatigue, weight gain,constipation,depression,dry skin,intolerance to cold,menstural irregularities

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12
Q

First line- hypothyroidism

A

levothyroxine
Monitor TSH: every 3 months until stable, then yearly thereafter
Take medicine in the morning, at least 30 minutes before having breakfast or caffeinated drinks
MHRA - New guidance that a small proportion of patients can feel symptoms if alternating between brands

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13
Q

Liothyronine

A
  • More rapid and potent output (20-25mcg=100mcg of levothyroxine)
    • Non-uk brands may not be bio equivalent
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