Thyroid Flashcards
What’s the difference between primary and secondary hyperthyroidism?
Primary: pathology within thyroid gland
Secondary: thyroid is stimulated by excess TSH
Causes of hyperthyroidism?
Grave's disease Toxic nodular goitre Toxic adenoma (producing T3/4) Thyroiditis Exogenous: drugs, iodine excess Post-partum
What is Grave’s disease?
Autoimmune: autoantibodies bind to TSH receptor stimulating the production of T3 and 4
Too much is produced
What TFT results would you see in Grave’s?
High T3 and 4
Low TSH as body recognises high T3/4 and tries to reduce TSH (negative feedback)
What are some Grave’s specific symptoms?
Goitre
Ophthalmopathy
Pretibial myxoedema
Clubbing
What is thyroiditis? Clinical features?
Post-viral, inflammation of thyroid
Painful goitre, high ESR, self-limiting
Clinical features of hyperthyroidism?
Weight loss High appetite Heat intolerance Oligomenorrhoea Diarrhoea Anxiety Palpitations Tremor Tachycardia, AF Pruritus
Investigations of hyperthyroidism?
Bloods: FBC (anaemia), TFTs, autoantibodies, LFTs
Management of hyperthyroid?
Drugs:
- B blockers (symptomatic)
- Carbimazole
Radioiodine
Thyroidectomy
Complications of hyperthyroidism?
Osteoporosis
IHD
Stroke
Thyrotoxic crisis
Thyrotoxicosis vs hyperthyroidism?
Thyrotoxicosis: high level of T hormones in the blood
Hyperthyroid: over-active thyroid
Symptoms of thyrotoxic crisis?
Pyrexia Vomiting Jaundice Delirium Seizures
Which drugs can cause hyperthyroidism?
Amiodarone
Lithium
Interferon-alpha
Causes of hypothyroidism?
Hashimoto’s thyroiditis
Iodine deficiency
Drugs
Pregnancy
What’s Hashimotos?
Autoimmune disease, where auto-antibodies attack the thyroid gland, causing inflammation and poor functioning
What are some Hashimoto’s specific features (symptoms and blood results)?
Painless irregular goitre
Anti TPO antibodies
How does iodine deficiency cause hypothyroidism?
Iodine is needed to make up T3 and T4
Clinical features of hypothyroidism?
Weight gain Constipation Cold intolerance Menorrhagia Fatigue, lethargy Low libido Memory impairment
Management of hypothyroidism?
Levo-thyroxine (artificial T4)
What are the proper names for T3 and 4?
T3: triiodothyronine
T4: thyroxine
Complications of hypothyroidism?
Hyperlipidaemia
Hyponatraemia
