thyroid disease

Question 1

Primary v secondary in thyroid pathologies

Answer 1

primary: due to a thyroid problem
secondary: due to hypothalamic/ pituitary problem.

Question 2

What pathology may a patient with a goitre have

Answer 2

Hyper/Hypo/Euthyroid

Question 3

What effect does a retrosternal goitre have on the trachea

Answer 3

Deviates the trachea.

Question 4

What are some thyroid function tests

Answer 4

TSH- 0.3-4.2 mu/l
FT4- 12–22 pmol/l
FT3- 3.1-6.8 pmol/l

Thyroid autoantibodies: anti-TPO AB, TRAB ( TSH receptor autoantibody)

Question 5

Why is TSH measured and what should be kept in mind

Answer 5

Best biomarker of thyroid status- pituitary saying if Thyroid hormone is too high, perfect or low

things to remember:
slow to respond to change in thyroid status (about 6 weeks) so not the best marker in an acute setting

By using TSH as a marker assumes the Pituitary is fine, won’t make sense in someone with pituitary disease.

Question 6

What are the 2 diff types of thyroid autoantibodies

Answer 6

Destructive- target thyroid for autoimmune destruction

stimulatory- stimulate TSH receptor

Question 7

What are the symptoms of hypothyroidism

Answer 7

asymptomatic, lethargy, mild weight gain, cold intolerance, constipation, facial puffiness, dry skin, hair loss, hoarseness, heavy menstrual period

Question 8

What are the signs of severe hypothyroidism

Answer 8

change in appearance: puffy n pale face
periorbital oedema
dry flaking skin
diffuse hair loss
bradycardia
signs of carpal tunnel syndrome
effusions e.g. ascites, pericardial
goitre, croaky voice.

Question 9

What are the causes of primary hypothyroidism

Answer 9

Autoimmune hypothyroidism
hypo post-treatment for hyperthyroidism
thyroiditis
drugs (lithium, amiodarone)
congenital hypothyroidism
iodine deficiency

Question 10

What are the causes of secondary hypothyroidism (rare)

Answer 10

diseases of of the hypothalamus or pituitary