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Homeostasis > Thyroid disease > Flashcards

Thyroid disease Flashcards

1
Q

symptoms of thyrotoxicosis

A

diarrhoea, weight loss, appetite increase,sweats, heat intolerance, palps, tremor, irritable. rare- pyschosis, chorea

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2
Q

signs of thyrotoxicosis

A

pulse fast/irregular, warm moist skin, fine tremor, palmar erythema, lid lag, lid retraction, goitre, thyroid nodules, bruits

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3
Q

what is Graves disease, typical age and male to female ratio

A

hyperthyroidism, 40-60 years, 9:1 female:male

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4
Q

signs of Graves disease

A

exophthalmos, opthalmoplegia, pretibial myxoedema, clubbing, painful finger and toe swelling, periosteal reaction in limb bones

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5
Q

tests for thyrotoxicosis

A

TSH down, T4 and T3 up. mild normocytic anaemia, mild neutropenia, ESR up, Ca up, LFT up

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6
Q

cause of Graves

A

circulating IgG autoantibodies bind to and activate GPCR thyrotropin receptors- smooth thyroid enlargement and increased hormone production

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7
Q

triggers of Graves

A

stress, infection, childbirth

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8
Q

what are the causes of thyrotoxicosis

A

Graves, toxic multinodular goitre, toxic adenoma, ectopic thyroid tissue, exogenous (iodine excess, levothyroxine excess).

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9
Q

what are the diffuse causes of goitre

A

physiological, Graves, Hashimotos thyroiditis, subacute (de Quervain’s) thyroiditis

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10
Q

what are the nodular causes of goitre

A

multinodular goitre, adenoma, carcinoma

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11
Q

how can you treat thyrotoxicosis

A

drugs- b blockers, carbimazole; radioiodine (CI- pregnancy, lactation); thyroidectomy

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12
Q

complications of thyrotoxicosis

A

heart failure (thyrotoxic cardiomyopathy), angina, AF, osteoporosis

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13
Q

how many Graves patients present with thyroid eye disease and what is the main known risk factor

A

25-50%. smoking

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14
Q

what is the medical emergency associated with hyperthyroidism

A

thyroid storm

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15
Q

what are the manifestations of Graves- heart

A

incr rate, incr contractility

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16
Q

what are the manifestations of Graves- liver

A

incr peripheral T3, decr LDL

17
Q

what are the manifestations of Graves- bone

A

incr bone turnover, osteoporosis

18
Q

what are the manifestations of Graves- genital

A

male- decr libido and erectile dysfunction, female- irregular menses

19
Q

what are the manifestations of Graves- metabolic, fat

A

thermogenesis, incr O2 use; decr fat mass

20
Q

what are the manifestations of Graves- CNS

A

stiff person syndrome

21
Q

what are the manifestations of Graves- muscle

A

proximal myopathy

22
Q

what are the manifestations of Graves- thyroid

A

incr secretion T3 and T4

23
Q

more common age and gender of hypothyroidism

A

> 40 years, female 6:1

24
Q

symptoms of hypothyroidism

A

tired, sleepy, lethargic, mood decr, cold disliking, weight incr, constipation, hoarse voice, decr memory, dementia, myalgia, weakness

25
Q

signs of hypothyroidism

A

BRADYCARDIC- Reflexes relax slowly, Ataxia, Dry thin hair/ skin, Yawning/drowsy/coma, Cold hands, Ascites +/- non pitting oedema, Round puffy face, Defeated demeanour, Immobile, CCF. neuropathy, myopathy, goitre

26
Q

diagnosis of hypothyroidism

A

TSH incr T4 decr

27
Q

causes of primary autoimmune hypothyroidism

A

primary atrophic hypothyroidism; Hashimotos thyroiditis

28
Q

what is Hashimotos thyroiditis

A

goitre due to lymphocytic and plasma cell infiltration

29
Q

what is the main cause of hypothyroidism worldwide

A

iodine deficiency

30
Q

what are the causes of primary hypothyroidism

A

iodine deficiency, post thyroidectomy or radioiodine treatment, drug induced, subacute thyroiditis

31
Q

what occurs in secondary hypothyroidism

A

not enough TSH, rare, hypopituitarism

32
Q

what are the pregnancy problems associated with hypothyroidism

A

eclampsia, anaemia, prematurity, decr birthweight, stillbirth, PPH

33
Q

what are the associated conditions with hypothyroidism

A

Turners, Downs, CF, primary biliary cirrhosis

34
Q

what is the treatment for hypothyroidism

A

levothyroxine (T4).

Homeostasis (14 decks)

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