Thyroid/ Cushings/ Addisons Flashcards
Does Hashimoto’s thyroiditis cause hypo or hyper
Hypo
However, in acute phase can het hyper before hypo
Does Hashimoto’s present with a goitre?
Yes, usually PAINLESS
Antibodies associated with Hashimoto’s
Anti TPO, anti TG
Most common cause of hypothyroidism in children
In the developed world: Autoimmune thyroiditis
In the developing world: Iodine deficiency
What cancer is Hashimoto’s associated with the development of?
MALT lymphoma
Does graves cause hypo or hyper
Hyper
Most common cause of thyrotoxicosis
Graves
What features do you get in graves but not other forms of thyrotoxicosis?
eye signs (30% of patients)
exophthalmos
ophthalmoplegia
pretibial myxoedema
thyroid acropachy, a triad of:
digital clubbing
soft tissue swelling of hands and feet
periosteal new bone formation
Antibodies associated with graves
Anti TPO
TSH receptor stimulating antibodies (
What would TFTs look like in sick euthyroid?
it is often said that everything (TSH, thyroxine and T3) is low. In the majority of cases however the TSH level is within the >normal range
Is subacute thyroiditis hypo or hyper?
Hyper.
4 phases of subacute thyroiditis
phase 1 (lasts 3-6 weeks): hyperthyroidism, painful goitre, raised ESR
phase 2 (1-3 weeks): euthyroid
phase 3 (weeks - months): hypothyroidism
phase 4: thyroid structure and function goes back to normal
what is subclinical hypothyroidism?
TSH high, T3/T4 normal.
How to manage subclinical hypothyroidism
TSH more than 10, free thyroxine normal - Repeat in 3 months. If TSH remains above 10 then consider offering levothyroxine.
TSH 5.5 - 10, free thyroxine normal - Repeat again in 3 months.
if < 65 and its the same when repeated, AND there are sx of hypo, consider offering a 6-month trial of levothyroxine.
In older people ‘watch and wait,’ rat in 6 months.
What will electrolytes be doing in Addisons?
Low sodium, high potassium.
