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CLP - Endocrinology > Thyroid Disease > Flashcards

Thyroid Disease Flashcards

1
Q

hyperthyroidism age and gender prevalence?

A

F>M 5:1

20-40

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2
Q

hyperthyroidism TSH and T3/4 levels?

A

LOW TSH

HIGH T3/4

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3
Q

causes of hyperthyroidism

A 
Graves' 
toxic multinodular goitre
solitary toxic adenoma
drug induced: levothyroxine, amiodarone
hashitotoxicosis
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4
Q

what is Grave’s disease?

A

IgG autoAb stimulate thyroid follicular out of control

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5
Q

signs of Grave’s

A 
opthalmopathy
lagopthalmos
exopthalmos
opthalmoplegia
peri-orbital oedema
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6
Q

what antibodies are found in Graves’?

A

TPO

TSH-R

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7
Q

signs and symptoms of hyperthyroidism

A 
Sweating
Weight loss
Emotional lability
Appetite increase
Tremor
Intolerance to heat
Nervousness
GI disturbances/goitre
lid retraction
opthalmopathy
AF
tachycardia
pre-tibial myxoedema
systolic HTN
diarrhoea
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8
Q

how can you distinguish between Graves and toxic nodular goitre?

A

technetium uptake scan
diffuse: Graves
one or more hot nodules: toxic nodular goitre
reduced/absent uptake: thyroiditis

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9
Q

management of hyperthyroidism

A 
surgery
RAI (non Graves)
1. carbimazole
2. propylthiouracil
(preferred substrate for TPO)
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10
Q

what are the SE of hyperthyroidism medication?

A

rashes
thrombocytopenia
agranulocytosis
carbimazole - obstructive jaundice

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11
Q

hyperthyroidism gender prevalence?

A

F>M, 10:1

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12
Q

hypothyroidism TSH and T3/4 levels?

A

HIGH TSH

LOW T3/4

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13
Q

hypothyroidism causes

A

autoimmune: Hashimoto’s
atrophic thyroiditis
drugs: amiodarone, iodine excess, lithium
iodine deficiency

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14
Q

which causes of hypothyroidism cause a goitre?

A

Hashimotos - symmetrical goitre

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15
Q

what is Hashimoto’s?

A

T cell destruction of gland and B cell secretion of inhibitory TSH-R Ab

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16
Q

hypothyroidism investigations

A

FBC: anaemia
TPO Ab: Hashimoto’s
cholesterol: increased in hepatic hypothyroidism
CK: increased in muscle hypothyroidism

17
Q

hypothyroidism management

A

levo-thyroxine (L-T4)

18
Q

hypothyroidism signs and symptoms

A 
Memory loss
Obesity
Menorrhagia
Skin and hair dry
Onset slow
Tiredness
Intolerance to cold
Raised BP
Energy levels low
Depression
constipation
hair loss
anaemia
goitre
hoarse voice
hyporeflexia
19
Q

what is a goitre? how can it be described?

A

painless enlargement of thyroid gland

diffuse/nodular, simple/toxic, benign/malignant

20
Q

differentials of a diffuse goitre

A 
puberty
pregnancy
Graves
Hashimotos
de Quervains/Riedel's thyroiditis
iodine def
anti-thyroid drugs, lithium, amiodarone
21
Q

differentials of a nodular goitre

A 
MULTI:
toxic multinodular goitre
subacute thyroiditis 
SOLITARY:
follicular adenoma
benign nodule
thyroid Ca
lymphoma
mets
INFILTRATION
TB, sarcoid

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