thyroid

Question 1

thyroid hormones control

Answer 1

metabolic rate of tissues

Question 2

which hormone does the thyroid gland mainly secrete

Answer 2

T4

Question 3

how do you get T3

Answer 3

peripheral conversion of T4

Question 4

essential thing for thyroid hormone production

Answer 4

iodine

Question 5

how is thyroid hormones in plasma

Answer 5

bound to plasma proteins

Question 6

most common plasma protein T3 and T4 bind to

Answer 6

thyroxine-binding globulin

Question 7

thyroid function test

Answer 7

TSH and T3 and T4

Question 8

what increases TBG

Answer 8

oestrogen

Question 9

which people have an increased TBG

Answer 9

people on oral contraceptive

preggos

Question 10

when should you not bother assessing thyroid function

Answer 10

sick euthyroid syndrome e.g. pneumonia

Question 11

name a drug that causes thyroid disorder

Answer 11

amioderone

Question 12

who is hypothyroidism common in

Answer 12

women

Question 13

most common cause of hypothy

Answer 13

autoimmune thyroiditis

Question 14

autoimmune thyroiditis and goitre disease

Answer 14

hashimotos

Question 15

what is autoimmune thyroiditis also associated with

Answer 15

addisons

pernicious anaemia

Question 16

pernicous anaemia

Answer 16

autoimmune destruction of parietal cells = no IF = no B12

Question 17

drugs which can induce hypothy

Answer 17

carbimazole, lithium, amiodarone and interferon

Question 18

another substance that can cause hypothyroidism in people who already have problems

Answer 18

iodine

Question 19

‘myxoedema’

Answer 19

accumulation of mucopolysaccharide in subcutaneous tissues

Question 20

when should you investigate hypothyroidism in women

Answer 20

oligomenorrhoea/amenorrhoea, menorrhagia, infertility and hyperprolactinaemia

Question 21

hypothy treatment

Answer 21

levothyroxine

Question 22

subclinical hypothy

Answer 22

slightly increased serum TSH and normal free T4 concentration

Question 23

Myxoedema coma

Answer 23

confusion and coma, hypothermia, cardiac failure, hypoventilation, hypoglycaemia and hyponatraemia

Question 24

three main causes of hyperthy

Answer 24

graves, toxic adenoma and toxic multinodular goitre

Question 25

graves

Answer 25

IgG antibodies bind to the TSH receptor stimulating thyroid hormone production

Question 26

other diseases graves is associated with

Answer 26

pernicious anaemia and myasthenia gravis

Question 27

de Quervain’s thyroiditis

Answer 27

acute inflammation of gland by viral infection = transient hyperthy

Question 28

treatment of de Quervain’s thyroiditis

Answer 28

aspirin

Question 29

symptoms exclusive to graves

Answer 29

Ophthalmopathy, pretibial myxoedema and thyroid acropachy

Question 30

pretibial myxoedema

Answer 30

raised, purple-red symmetrical skin lesions over anterolateral aspects of the shins

Question 31

thyroid acropachy

Answer 31

clubbing, swollen fingers and periosteal new bone formation

Question 32

TSH level in hyperthy

Answer 32

suppressed

Question 33

hypothy symptoms gen

Answer 33

Tiredness/malaise, Weight gain, Cold intolerance, Goitre, Arthralgia, Myalgia, Muscle weakness/ stiffness, Poor libido, Deafness, Constipation, Anorexia

Question 34

hypothy symptoms brain

Answer 34

Depression, Psychosis, Coma, Poor memory

Question 35

hypothy symptoms appearance

Answer 35

Hair – dry, brittle, unmanageable Skin – dry, coarse, Puffy eyes

Question 36

hypothy signs

Answer 36

Loss of eyebrows, Hypertension, Hypothermia, Heart failure, Bradycardia, Pericardial effusion, Cold peripheries, Carpal tunnel syndrome, Oedema Periorbital oedema, Deep voice, (Goitre) Dry skin, Mild obesity, Myotonia, Muscular hypertrophy, Proximal myopathy, Slow-relaxing reflexes, Anaemia

Question 37

hyperthy symptoms

Answer 37

Weight loss Irritability/behaviour change Restlessness Malaise Itching Sweating Tall stature (in children) Breathlessness Palpitations Heat intolerance Stiffness Muscle weakness Tremor Thirst Vomiting Diarrhoea Eye complaints* Oligomenorrhoea Loss of libido Gynaecomastia Onycholysis

Question 38

hyperthy management

Answer 38

drugs surgery radioactive iodine

Question 39

hyperthy drugs

Answer 39

Carbimazole and PTU

Question 40

carbimazole function

Answer 40

lock thyroid hormone biosynthesis and also have immunosuppressive effects

Question 41

symptomatic relief of hyper

Answer 41

betablockers

Question 42

most severe side effect of carbimzole

Answer 42

agranulocytosis

Question 43

when to stop carbimazole

Answer 43

fever or sore throat

Question 44

when is radioactive iodine contraindicated

Answer 44

pregnancy | breast feeding

Question 45

thyroid storm

Answer 45

rapid deterioration of thyrotoxicosis with hyperpyrexia, tachycardia, extreme restlessness and eventually delirium, coma and death

Question 46

thyroid storm treatment

Answer 46

carbimazole, propranolol , potassium iodide to block acutely the release of thyroid hormone from the gland and hydrocortisone to inhibit peripheral conversion of T4 to T3

Question 47

how to determine whether nodules are cystic or solid

Answer 47

ultrasound