Thyroid Disease

Question 1

Symptoms of hypothyroidism

Answer 1

Tiredness
Cold intolerance
Weight gain
Depression
Dry skin and hair

Question 2

Pathophysiology of hyperthyroidism

Answer 2

Graves’ disease = autoimmune
Auto antibody binds to TSH receptors on thyroid follicles, stimulate increased thyroid release

Can also be due to thyroid/pituitary adenoma, hypothalamic dysfunction or thyroid nodules

Question 3

Pathophysiology of hypothyroidism

Answer 3

Hashimotos disease: autoantibody blocks TSH receptor, leads to destruction of thyroid cell and less thyroid hormone release.

Can also be due to pituitary/hypothalamic dysfunction or iodine deficiency

Question 4

Investigations of thyroid disease

Answer 4

Thyroid function tests - measure T3/T4/TSH levels

Question 5

Management of thyroid disease

Answer 5

Hyperthyroid: give carbimazole - prevents thyroid peroxidase enzyme from iodinating tyrosine residues, so reduces thyroxine production

Hypothyroidism: give hormone replacement - levothyroxine

Question 6

Complications of thyroid disease

Answer 6

Thyroid eye disease -> red, swollen, retracted eyelids, bulging eyes, dryness, double vision

Pregnancy problems: pre-eclampsia, miscarriage, premature birth

Atrial fibrillation, heart failure

Goitre

Question 7

Symptoms of hyperthyroidism

Answer 7

Heat intolerance
Tiredness
Anxiety and irritability
Goitre
Difficulty sleeping
Palpitations
Weight loss