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ENDOCRINE - RIA > thyroid > Flashcards

thyroid Flashcards

1
Q

what cells release parathyroid hormone

A

chief cells in Parathyroid gland

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2
Q

parathyroid hormone effect on calcium levels

A

raise calcium levels

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3
Q

what 4 ways does PTH increase calcium

A

1) Increase osteoclast activity in bones
2) increase calcium absorption from gut
3) increase calcium absorption from kidneys
4) increasing vitamin D activtiy

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4
Q

pneumonic for hypercalcaemia…

A

renal stones, painful bones, abdominal groans & psychiatric groans

  • renal stones
  • painful bones
  • constipation, nausea & vomiting
  • fatigue, depression & psychosis
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5
Q

PTH & calcium levels in primary hyperparathyroidism

A

high PTH

high Calcium

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6
Q

cause and managemnt of primary hyperparathyroidism

A

cause: tumour of parathryoid gland
management: surgical removal of tumour

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7
Q

cause of secondary hyperparathyroidism?

A

insufficient Vitamin D or chronic renal failure

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8
Q

PTH & calcium levels in secondary hyperparathryoidism

A

PTH is high

Calcium is low/normal

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9
Q

management of secondary hyperparathyroidsm

A

correcting vit D deficiency or renal transplant

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10
Q

untreated secondary hyperparathryodism for long periods of time leads to?

A

tertiary hyperparathyroidism

high PTH
high Calcium

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11
Q

most common cause of Hyperthyroidism in UK

A

Graves disease

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12
Q

2nd most common cause of hyperthyroidism in Uk

A

toxic multinodular goitre

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13
Q

medication that can cause both hyper or hypothyroidism

A

amiodarone

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14
Q

What is Struma ovarii

A

hyperthyroidism caused by ectopic tyroid tissue related to ovarian teratomas & dermoid tumours

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15
Q

what does the thryroud gland wrap around

A

thyroid cartilage

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16
Q

histology of thyroid gland?

A

made up of thyroid follicles & lined with columnar epithelium

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17
Q

marker for medullary carcinoma

A

calcitonin

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18
Q

painful cystic swelling in midline of neck

A

thryroglossal cyst

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19
Q

neck lump that moves on protrusion of tongue

A

thyroglossal cyst

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20
Q

neck lump that increases in size on swallowing

A

Pharyngeal pouch

21
Q

neck lump - patient may experience a bout of coughing & choking when lying down flat

A

pharyngeal pouch

22
Q

describing a lump/mass

A
  • site
  • size
  • shape
  • consistency
  • surface
  • colour
  • fluid thrill
  • tenderness
  • pulsatility
  • mobility & movement
  • can you get above or below the mass
23
Q

4 graves specific features

A
  • thyroid acropachy
  • ophthalmoplegia
  • exolpthalmos
  • pretibial myxoedema
24
Q

describe pretibial myxoedema

A

raised red-purple symmetrical skin lesions over anterolateral shins

due to deposition of mucopolysaccharides in the skin

25
Q

how is severity of Graves ophthalmopathy graded?

A

NOSPECS pneumonic

N - No signs or symptoms 
O - Only signs 
S - Soft tissue involvement 
P - Proptosis 
E - Extra ocular involvement 
C - Corneal involvement 
S - Sight loss
26
Q

features of graves eye disease

A
  • proptosis
  • periorbital oedema
  • lid retraction
  • eye pain
  • visual loss
27
Q

what antibody is seen in graves disease

A

TSH- receptor Ab

28
Q

3 causes of hyperthyroidism

A
  • graves disease
  • Toxic multinodular goitre
  • Toxic adenoma
29
Q

1st line medications for hyperthryoidosm

A
  • Carbimazole

- Propylthiouracil

30
Q

symptomatic medx for hyperthyroidism

A
  • Propranolol

- CCB

31
Q

CI for radioactive iodine

A
  • pregnancy

- breastfeeding

32
Q

1st line definitive trx for toxic multinodular goitre

A
  • radioactive iodine

it is taken up by the thyroid causing destruction & reduced thyroid hormone release

33
Q

when is Propythiouracil used 1st line instead of carbimazole?

A
  • patient in 1st trimester of pregnancy

- in a thyroid storm

34
Q

severe side effect of Carbimazole & Propylthiouracil

A

Agranulocytosis

35
Q

what does block & replace treatment involve?

A

Carbimazole started and patient started on levothyroxine when the patient is euthyroid

36
Q

complications post hemithyroidectomy surgery (2)

A

recurrent laryngeal nerve injury

hypocalcaemia

37
Q

treatment for more severe graves eye disease (3)

A

Referral to ophthalmologist is required if there is evidence of optic nerve compression, corneal opacity, inability to close eye

  • steroids
  • irradiation
  • surgical decompression
38
Q

presentation of Thryotoxic crisis

A
  • agitation seizure
  • abdominal pain
  • v & d
  • hyperreflexia
  • tachycardia
  • arrhythmia
  • heart failure
39
Q

most common thyroid cancer

A

papillary

40
Q

what cells do medullary thyroid carcinoma derive from

A

Calcitonin C cells

41
Q

most common cause of primary hypothyroidism in the western world?

A

Autoimmune disease - Hashimoto’s thyroiditis

42
Q

what 2 genetic conditions are associated with Hashimotos

A

Turner’s & down’s syndrome

43
Q

worldwide leading cause of hypothyroidism

A

iodine deficiency

44
Q

post viral infection?

A

Subacute de quervans thyroiditis

45
Q

goitre features in hashimotos

A

firm & non tender

46
Q

TFT in patient with poor compliance with thyroxine

A

High TSH

& normal free T4

47
Q

steroid therapy affect on TFT

A

TSH low

48
Q

autoantibodies seen in hashimotos (2)

A

Anti TPO
&
antithyroglobulin antibodies

ENDOCRINE - RIA (7 decks)

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