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year 2 - endocrine > thyroid disease > Flashcards

thyroid disease Flashcards

1
Q

what is Grave’s disease

A
  • most common cause of primary hyperthyroidism
  • production of antibodies that stimulate T3/T4 production and release in the absence of TSH
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2
Q

name 6 causes of hyperthyroidism

A
  • Grave’s
  • nodular disease
  • subacute Dequervain’s thyroiditis
  • pregnancy
  • drugs (e.g. amiodarone, lithium, levothyroxine)
  • metastatic thyroid cancer
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3
Q

what is subacute Dequervain’s thyroiditis

A
  • post viral transient inflammation of the thyroid gland
  • patients tend to go from hyper to hypo then back to normal
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4
Q

subacute Dequervain’s thyroiditis presentation

A
  • painful goitre
  • pyrexia
  • raised inflammatory markers
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5
Q

subacute Dequervain’s thyroiditis management

A

NSAIDs

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6
Q

Grave’s most common in

A

women 40-60

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7
Q

Grave’s specific signs

A
  • pre-tibial myxoedema
  • bilateral exopthalmos
  • thyroid acropachy
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8
Q

hyperthyroidism general presentation

A
  • heat intolerance
  • sweating
  • fatigue
  • weight loss
  • increased appetite
  • reduced concentration
  • swelling in the neck
  • difficulty sleeping
  • changes in menstrual pattern
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9
Q

hyperthyroidism ophthalmology presentation

A
  • gritty sensation in eye
  • eye discomfort
  • double vision
  • photophobia
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10
Q

hyperthyroidism motor presentation

A

tremor

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11
Q

hyperthyroidism cardiovascular presentation

A

palpitations

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12
Q

hyperthyroidism GI presentation

A

diarrhoea

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13
Q

hyperthyroidism dermatology presentation

A
  • moist skin or lumps on shins
  • fine brittle hair
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14
Q

hyperthyroidism mood presentation

A
  • anxiety
  • irritability
  • emotional liability
  • psychosis
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15
Q

hyperthyroidism signs

A
  • sweating
  • tremor
  • tachycardia
  • atrial fibrillation
  • moist skin
  • pre-tibial myxoedema
  • thyroid swelling that moves up and down with swallowing
  • lid lag
  • lid retraction
  • chemosis
  • exophthalmosis
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16
Q

primary hyperthyroidism thyroid function test results

A
  • high T3/T4
  • low TSH
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17
Q

secondary hyperthyroidism thyroid function test results

A
  • high T3/T4
  • high TSH
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18
Q

sub-acute hyperthyroidism thyroid function test results

A
  • normal T3/T4
  • high TSH
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19
Q

hyperthyroidism diagnosis

A
  • thyroid function tests
  • scintigraphy
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20
Q

multi-nodular hypethyroidism scintigraphy results

A

high uptake in multiple locations

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21
Q

toxic adenoma hypethyroidism scintigraphy results

A

single nodule of high uptake

22
Q

toxic adenoma hypethyroidism scintigraphy results

A

reduced uptake

23
Q

hyperthyroidism management

A
  • propranolol (symptomatic control)
  • carbimazole (risk of agranulocytosis and jaundice)
  • propylthiourcail
  • radio-ablation
  • thyroidectomy
24
Q

secondary hyperthyroidism causes

A
  • pituitary disease
  • hypothalamic disease
25
Q

what is a thyroid storm

A
  • complication of hypetthyroidism
  • state of severe hyperthyroidism
26
Q

thyroid storm causes

A
  • MI
  • infection
  • radio-iodine
  • recent thyroid surgery
27
Q

thyroid storm presentation

A
  • agitation, confusion, coma
  • thyroid bruit
  • seizure/coma
  • tachycardia, atrial fibrillation, heart failure, circulatory collapse
  • acute abdomen, diarrhoea/vomiting, abdominal pain, jaundice
28
Q

thyroid storm management

A
  • IV beta blockers
  • fluids
  • cool patient
  • thyroidectomy if not resolved within 24 hours
29
Q

name 5 causes of hypothyroidism

A
  • Hashimoto’s thyroiditis
  • atrophic thyroiditis
  • idiodine deficiency
  • post thyroiectomy/radio-ablation
  • drugs (e.g. lithium, amiodarone, anti-thyroid drugs)
30
Q

Hashimoto’s most common in

A

women > 60

31
Q

what cancer is Hashimoto’s associatied with

A

B cell non-Hodgkin’s lymphoma

32
Q

hypothyroidism presentation

A
  • weight gain
  • tiredness
  • fatigue
  • peri-orbital swelling
  • constipation
  • menorrhagia, infertility
  • depression, reduced memory, dementia
  • dry skin, coaese hair, hair loss, loss of outer 1/3 of eyebrow
33
Q

hypothyroidism signs

A
  • cold peripheries
  • facial puffiness
  • non-pitting oedema on hands and feet
  • ataxis
  • slow, relaxing reflexes
  • dry, thin hair and dry skin
34
Q

hypothyroidism diagnosis

A
  • autoantibodies (Hashimoto’s = anti-thyroid peroxidase, anti-thyroglobulin and TRAB blocking)
  • thyroid function tests
35
Q

primary hypothyroidism thyroid function test results

A
  • low T3/T4
  • high TSH
36
Q

secondary hypothyroidism thyroid function test results

A
  • low T3/T4
  • low TSH
37
Q

subclinical hypothyroidism thyroid function test results

A
  • normal T3/T4
  • high TSH
38
Q

hypothyroidism management

A

levothyroxine

39
Q

secondary hypotyroidism causes

A

pituitary or hypothalamic disease

40
Q

what is myxoedema coma

A
  • complication of hypothyroidism
  • ultimate state of hypothyroidism before death
41
Q

myxoedema coma causes

A
  • MI
  • infection
  • untreated hypothyroidism
  • post-pituitary surgery/thyroidectomy
  • radio-iodine
42
Q

myxoedema coma presentation

A
  • psychosis, coma, seizures
  • hypothermia, hyporeflexia, hypoglycaemia
43
Q

myxoedema coma diagnosis

A
  • thyroid function test
  • baseline bloods
44
Q

myxoedema coma management

A
  • correct hypoglycaemia
  • actively warm patient
  • T3 infusion
  • hydrocortisone
45
Q

most common thyroid cancer

A

papillary thyroid cancer

46
Q

papillary thyroid cancer histology findings

A
  • orphan Annie nuclei
  • calcified psammoma bodies
47
Q

best thyroid cancer prognosis

A

papillary

48
Q

name 5 thyroid cancer subtypes

A
  • papillary
  • follicular
  • medullary
  • anaplastic
  • lymhoma
49
Q

medullary thyroid cancer pathophysiology

A
  • malignancy of parafollicular cells
  • associated with abnormal secretion of malcitonin and hypercalcaemia
50
Q

medullary thyroid cancer associated syndrome

A

MEN

51
Q

worst thyroid cancer prognosis

A

anaplastic

year 2 - endocrine (6 decks)

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