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203 > Thyroid Disease > Flashcards

Thyroid Disease Flashcards

1
Q

Bruit?

A

Extreme amounts of blood flowing through thyroid

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2
Q

Retrosternal goitre causes?

A

Deviation of trachea

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3
Q

How many people have thyroids checked?

A

1 in 4

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4
Q

Thyroid autoantibodies?

A

Anti TPO AB thyroid peroxidase- adds iodine to thyroglobulin.

TSH receptor TRAB

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5
Q

Symptoms of hypothyroidism?

A

Lethargy, mild weight gain, cold intolerance, constipation, facial puffiness, dry skin, hair loss, hoarseness and heavy menstrual periods

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6
Q

Severe hypothyroidism?

A

Stupor or coma, median nerve compression, ascites etc

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7
Q

Causes of hypothyroidism?

A
  1. Autoimmune
  2. Iatrogenic
  3. Iodine deficiency
  4. Congenital hypothyroidism
  5. Drugs
  6. Thyroditis

Addict

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8
Q

Secondary hypothyroidism hormone level?

A

TSH, T3 and T4 low

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9
Q

Treat of hypothyroidism?

A

T4 100 micro gram daily

If old and ishchaemic heart disease, start at 25 to 50

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10
Q

Myxedema?

A

Accumulation of glycosaminoglycans in interstitial space of tissues, severe hypothyroidism

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11
Q

Symptoms of thyrotoxicosis, hyperthyroidism?

A

Weight loss, increased appetite, lack of energy, thirst, palpitations, heat intolerance, anxious irritable, oligomenorrhoea

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12
Q

Signs of thyrotoxicosis?

A

Tremor, warm moist skin, tachycardia, brisk reflex, eye signs, thyroid bruit, muscle weakness and atrial fibrillation

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13
Q

Thyroid eye disease?

A

20% of people with Graves’ disease

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14
Q

TED symptoms?

A

Itchy, dry eyes, prominent eyes.
Diplopia (double vision), loss of colour vision, redness and swelling of conjunctival unable to close eyes, tightness behind eye

Inflammation of all orbital tissues except eye

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15
Q

Proptosis?

A

Pushing forward of eyes

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16
Q

Opthamolplegia?

A

When eyes don’t move smoothly

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17
Q

Causes of thyrotoxicosis?

A
  1. Graves- accounts for 75%
  2. Toxic multinodular goitre
  3. Toxic adenoma
  4. Thyroiditis
  5. Drugs (amiodarone )
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18
Q

What % of hyperthyroidism is graves?

A

75

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19
Q

Gestational thyrotoxicosis?

A

Placental beta human chorionic gonadotrophin act like TSH

20
Q

Symptom control for graves?

A

Beta blockers, propranolol, not in asthmatics

21
Q

Medical therapy for hyperthyroidism

A

Carbimazole or propylthiouracil
18 months to 2 year.
Rare side effect- agranulocytosis

22
Q

Long term cure medication?

A

1/3

23
Q

Severe thyroid eye disease?

A

Worsens with radioiodine

24
Q

Which hormone takes longer to re-equilibrium?

A

TSH, monitor T4

25
Q

Thyroid eye disease treatment?

A

Radiotherapy, immunosuppressive steroid-sparing agents, pulsed iv methylpred oral prednisolone, orbital decompression, eyelid surgery, stop smoking

26
Q

Thyroid storm causes?

A

Multisystem condition
Surgery childbirth
Acute severe illness: PE, stroke, diabetic ketoacidosis, infection trauma

27
Q

Thyroiditis?

A

Mild thyrotoxicosis, may use beta blockers
Then long hypothyroid phase, may use thyroxine.
Triggered by viral or pregnancy

28
Q

Drugs that affect thyroid function?

A

Lithium- inhibits thyroid hormone secretion synthesis

and amiodarone

29
Q

Thyroid nodule, cancer percentage?

A

5

30
Q

How to treat toxic adenoma or toxic multinodular goitre?

A

Short term medical therapy then radioiodine

31
Q

Causes of hypothyroidism?

A
  1. Graves
  2. Toxic Multinodular goitre
  3. Toxic Adenoma
  4. Thyroiditis
  5. Drugs
32
Q

Thyroid eye disease may be graves in what percent of the cases?

A

20

33
Q

Goitre with a bruit is?

A

Graves

34
Q

To test for graves what scan should you do and what would you find?

A

Thyroid uptake scan, darker areas where increased activity

35
Q

What percent after radioiodine risk hypothyroidism?

A

40%

36
Q

When cant you use radioiodine?

A

Not in pregnant, breast feeding, in severe thyroid eye disease

37
Q

In order to do thyroidectomy patient must first be?

A

Euthyroid

38
Q

Treatment for a toxic adenoma or toxic multinodular goitre?

A

Short term medical therapy and then radioiodine

39
Q

Features of thyroid storm?

A 
Graves
Thyroid eye disease
Goitre
140 bpm<
High pyrexia
Atrial dysrhytmias
Ventricular dysfunction
Heart failure
CNS agitation/delirium
Vomiting
Diarrhoea
Heaptocellular dysfunction
40
Q

Consider thyroiditis in following patients?

A

If pregnant/ within 1 year post partum- increase risk of t1d
Very tender thyroid
Thyroid status does not fit lab
Not graves
Current/recurrent treatment of immunomodulatory meds

41
Q

How long does TSH take to change?

A

6 weeks

42
Q

Further investigations for graves?

A

Thyroid autoantibodies

Thyroid uptake scan

43
Q

Radioactive iodine treatment?

A

Radiation kills thyroid cells,

First do medical therapy until euthyroid

44
Q

How many people after radioactive iodine risk hypothyroidism?

A

40%

45
Q

What are the risks with thyroid surgery?

A 
Anaesthetic
Neck scar
Hypothyroidism
Hypoparathyroidism
Vocal cord palsy

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