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metabolic diseases > thyroid > Flashcards

thyroid Flashcards

1
Q

thyroid hormones control

A

metabolic rate of tissues

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2
Q

which hormone does the thyroid gland mainly secrete

A

T4

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3
Q

how do you get T3

A

peripheral conversion of T4

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4
Q

essential thing for thyroid hormone production

A

iodine

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5
Q

how is thyroid hormones in plasma

A

bound to plasma proteins

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6
Q

most common plasma protein T3 and T4 bind to

A

thyroxine-binding globulin

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7
Q

thyroid function test

A

TSH and T3 and T4

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8
Q

what increases TBG

A

oestrogen

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9
Q

which people have an increased TBG

A

people on oral contraceptive

preggos

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10
Q

when should you not bother assessing thyroid function

A

sick euthyroid syndrome e.g. pneumonia

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11
Q

name a drug that causes thyroid disorder

A

amioderone

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12
Q

who is hypothyroidism common in

A

women

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13
Q

most common cause of hypothy

A

autoimmune thyroiditis

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14
Q

autoimmune thyroiditis and goitre disease

A

hashimotos

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15
Q

what is autoimmune thyroiditis also associated with

A

addisons

pernicious anaemia

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16
Q

pernicous anaemia

A

autoimmune destruction of parietal cells = no IF = no B12

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17
Q

drugs which can induce hypothy

A

carbimazole, lithium, amiodarone and interferon

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18
Q

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

A

iodine

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19
Q

‘myxoedema’

A

accumulation of mucopolysaccharide in subcutaneous tissues

20
Q

when should you investigate hypothyroidism in women

A

oligomenorrhoea/amenorrhoea, menorrhagia, infertility and hyperprolactinaemia

21
Q

hypothy treatment

A

levothyroxine

22
Q

subclinical hypothy

A

slightly increased serum TSH and normal free T4 concentration

23
Q

Myxoedema coma

A

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

24
Q

three main causes of hyperthy

A

graves, toxic adenoma and toxic multinodular goitre

25
Q

graves

A

IgG antibodies bind to the TSH receptor stimulating thyroid hormone production

26
Q

other diseases graves is associated with

A

pernicious anaemia and myasthenia gravis

27
Q

de Quervain’s thyroiditis

A

acute inflammation of gland by viral infection = transient hyperthy

28
Q

treatment of de Quervain’s thyroiditis

A

aspirin

29
Q

symptoms exclusive to graves

A

Ophthalmopathy, pretibial myxoedema and thyroid acropachy

30
Q

pretibial myxoedema

A

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

31
Q

thyroid acropachy

A

clubbing, swollen fingers and periosteal new bone formation

32
Q

TSH level in hyperthy

A

suppressed

33
Q

hypothy symptoms gen

A

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

34
Q

hypothy symptoms brain

A

Depression, Psychosis, Coma, Poor memory

35
Q

hypothy symptoms appearance

A

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

36
Q

hypothy signs

A

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

37
Q

hyperthy symptoms

A

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

38
Q

hyperthy management

A

drugs
surgery
radioactive iodine

39
Q

hyperthy drugs

A

Carbimazole and PTU

40
Q

carbimazole function

A

lock thyroid hormone biosynthesis and also have immunosuppressive effects

41
Q

symptomatic relief of hyper

A

betablockers

42
Q

most severe side effect of carbimzole

A

agranulocytosis

43
Q

when to stop carbimazole

A

fever or sore throat

44
Q

when is radioactive iodine contraindicated

A

pregnancy

breast feeding

45
Q

thyroid storm

A

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

46
Q

thyroid storm treatment

A

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

47
Q

how to determine whether nodules are cystic or solid

A

ultrasound

metabolic diseases (11 decks)

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