Thyroid Flashcards
What is the definition of hypothyroidism?
Insufficient secretion of thyroid hormone due to an underachieve thyroid gland.
What is the cause of primary hypothyroidism?
Disease of the thyroid gland
What is the cause of secondary hypothyroidism?
Disease of the hypothalamus or the pituitary
What are the 5 types of hypothyroidism?
- Autoimmune
- Iatrogenic
- Drug induced
- Iodine deficiency
- Congenital
What % of the population develop hypothyroidism?
a. 6%
b. 2%
c. 20%
d. 13%
b. 2%
What gender is hypothyroidism more common in?
Women
Give 7 symptoms of hypothyroidism?
- Weight gain
- hair loss
- cold intolerance
- bradycardia
- dry skin & hair
- lethargic
- mood changes & mental slowness
- low libido
- goitre
- muscle weakness/stiffness
- tiredness
What blood results would you expect to find in hypothyroidism?
a. TSH- low T4- low
b. TSH- high T4- low
c. TSH- high T4- high
d. TSH- low T4- high
b. TSH- high T4- low
What is the primary management of hypothyroidism for a normal ‘healthy’ individual?
Levothyroxine (T4) 50-100mg 24hrly.
How often would you review a patient with hypothyroidism on 50-100mg of levothyroxine 24hrly?
Every 6 weeks according to response using thyroid function tests.
What is the primary management of hypothyroidism for a elderly/IHD patient?
Levothyroxine 25mg 24hrly.
How often would you review a patient with hypothyroidism on 25mg levothyroxine 24hrly?
Every 4 weeks according to response to treatment and TSH levels
What is the autoimmune condition of hypothyroidism called?
Hashimotos thyroiditis
Describe the pathogenesis of hashimotos thyroiditis?
Aggressive destruction of the thyroid cells which result in thyroid gland unable to enough thyroid hormones.
The auto antibodies bind to the TSH receptors and further impair the function of the thyroid gland
Is hashimotos thyroiditis more common in men or women?
Men
Give 3 examples of triggers of Hashimotos Thyroiditis?
- Smoking
- Medication
- infection
- iodine
What is myxoedema coma?
Severe hypothyroidism and is the ultimate state before death
What is the definition og hyperthyroidism?
Over active thyroid gland that results in excess production of thyroid hormones.
What are the 3 intrinsic thyroid disorders?
- Graves disease
- Toxic adenoma
- multi-nodular goitre
What factor can increase the risk of developing Graves disease?
Smoking
What is the most common cause of hyperthyroidism?
Graves disease
What is the pathogenesis of Graves disease?
B-cells IgG autoantibodies bind to the TSH receptor and stimulate excess thyroid hormone production.
What is the pathogenesis of toxic adenoma?
Follicular cells grow uncontrollably which lead to the development of a benign tumour that produce excess thyroid hormone
What is the pathogenesis of multi nodular goitre?
Mutated TSH receptor cause follicular cells to generate excess thyroid hormones.
Who is commonly affected by multi nodular goitre?
women
What % of women are affected by Graves disease?
2-5%
What age group are most likely to develop hyperthyroidism ?
30-50 years
What is the definition of thyroiditis?
Group of disorders that is characterised by some form of thyroid inflammation
What can thyroiditis often lead to?
thyrotoxicosis
Give 5 causes of thyroiditis?
Hashimotos Drug induced De Querevain postpartum thyroiditis Reidel thyroiditis
