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endocrine > thyroid > Flashcards

thyroid Flashcards

1
Q

Free T3/4 low
TSH high
?

A

primary hypothyroidism

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2
Q

Free T3/4 high

TSH low

A

Primary hyperthyroidism

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3
Q

Secondary hypothyroidism

values?

A 
Free T3/4 low
TSH low (or ‘normal’)
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4
Q

Secondary hyperthyroidism

values?

A 
Free T3/4 high
TSH high (or ‘normal’)
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5
Q

what is myxOedema ?

A

refers to severe hypothyroidism and is a medical emergency

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6
Q

Pretibial myxoedema ?

A

is a rare clinical sign of Graves’ disease, an autoimmune thyroid disease which results in hyperthyroidism!

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7
Q

hashimotos - hyper or hypothyroid?

A

hypothyroid

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8
Q

what is the most common cause of hypothyroid in the west?

A

autoimmune hypothyroidism (hashimotos thyroiditis)

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9
Q

hashimotos characterised by?

A

Antibodies against thyroid peroxidase (TPO)

T-cell infiltrate and inflammation microscopically

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10
Q

coarse, sparse hair, expressionless face, periorbital puffiness, pale cool skin that feels doughy to touch, vitiligo may be present . hyper or hypo

A

hypo

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11
Q

what is hypercaretonaemia

A

editing carotene in blood, can cause yellowing got skin

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12
Q

What happens to thermorgulation in hypo?

A

cold intolerance

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13
Q

Fluid in hypo?

A

get fluid retention

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14
Q

what is an autoimmune disease which is an associated cutaneous sign of hypothyroid?

A

vitiligo

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15
Q

what happens to lipids in hypo?

A

get hyperlipidaemia

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16
Q

4 cardiac changes in hypo?

A

reduced heart rate
cardiac dilatation
pericardial effusion
worsening of heart failure

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17
Q

Apeitite and weight?

A

reduced appetite and increased weight

18
Q

why might you get sleep apnoea in hypothyroid?

A

get hypoglossia (unusually large tongue)

19
Q

what can happen to the voice? hypo

A

hoarsness

20
Q

HYPO MUSCLES?

A

get muscle stiffness and cramps

21
Q

tendon reflexes?

A

prolongation of tendon jerks

22
Q

intellectual activities and motor activities

A

decreased

23
Q

Describe periods in hypothyroid?

A

menorrhagia and later get oligo or amenorrhoea

24
Q

why do you get hyperprolactinaemia?

A

increased TRH causes increased PRL secretion

25
Q

↑TSH and ↓fT4/3, creatinine kinase and LDL levels?

A

increased

26
Q

treating hypo, why should metabolic rate be restored gradually and not rapidly?

A

may precipitate cardiac arythmias

27
Q

what should levothyroxin dose be started at in younger patients

A

50-100ug

28
Q

in the elderly with history IHD, start levothyroxin at what daily?

A

25-50

29
Q

in secondary thyroid disease, where is the pathology?

A

not in the thyroid - hypothalamus or pituitary

30
Q

TSH should be checked every 12-18 weeks

A

check TSH 2 months after every dose change

31
Q

what is levothyroxin?

A

t4

32
Q

is t3 therapy used?

A

rarely, there is no benefit of taking t3 and t4 combined

33
Q

what happens to dose requirements in pregnancy?

A

they increase by 25-50%

34
Q

myx0edema coma )hypO, get oedema in hypo. What would you see on ECG

A

bradycardia, low voltage complexes, varying degrees of heart block, T wave inversion, prolongation of the QT interval

35
Q

management of myxoedema ?

A

Intensive care, remember – A, B, C!
Passively rewarm: aim for a slow rise in body temperature
Cardiac monitoring for arrhythmias
Close monitoring of urine output, fluid balance, central venous pressure, blood sugars, oxygenation
Broad spectrum antibiotics
Thyroxine cautiously (hydrocortisone)

36
Q

opposite of myx0edema?

A

thyrotoxicosis. the state arising when tissues exposed to ecess thyroxin

37
Q

thyrotoxicosis, which cardiac abnormality would you see?

A

atrial fibrilation, palpitation

38
Q

hyperthyroid, bowel movements?

A

diarrhoea

39
Q

eye changes in thyrotoxicosis?

A

lid retraction, diplopia, proptosis

40
Q

hair and nails?

A

brittle nails, rapid fingernail growth

endocrine (27 decks)

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