Thyroid Disease Flashcards
Primary thyroid disease affects the…
thyroid gland
Secondary thyroid disease affects the ….
hypothalamus or pituitary gland
What is the most common cause o hypothyroidisim in the West?
Hashimoto’s thyroiditis
-autoimmune destruction of the thyroid gland
What Antibodies are present in Hashimoto’s disease?
- anti-Thyroid Peroxidase antibodies
(TPO) - Anti-thyroglobulin antibody
What are the clinical features of hypothyroidisim?
Hair and skin:
- coarse hair
- periorbital puffiness
- pale cool skin, doughy to touch
- vitiligo (loss of melanocytes)
Thermogenesis:
-cold intolerance
Cardiac:
- reduced heart rate
- cardiac dilatation
Metabolic
- hyperlipidaemia
- decreased appetite
- weight gain
GI
-constipation
Respiratory
- hoarse voice
- obstructive sleep apnoea
Neurology
- peripheral neuropathy
- depression and low mood
Gynae/reproductive
-dysregulation of periods
What are the lab findings in hypothyroidism
- High TSH
2. Low T4/T3
What antibodies are detected in Grave’s disease?
- TSH receptor antibody
2. Anti-TPO (Thyroid Peroxidase) antibody
What drug is the mainstay of treatment in hypothyroidism?
Levothyroxine
-synthetic T4
_____ _____ is a very serious complication of long-standing hypothyroidism.
Myxoedema coma
What are the signs and symptoms of hyperthyroidism (thryotoxicosis)?
Cardiac:
- palpatation - Atrial Fibrillation
- Cardiac failure
Sympathetic:
-tremor, sweating
CNS:
-anxiety, irritability, sleep disturbance
GI:
-frequent, loose bowel movements
Vision
- Lid retraction
- double vision
- bulging eyes (Graves’)
Hair and nails:
- rapid nail growth
- brittle thin hair
Reproductive
-less frequent and lighter periods
Muscles:
-weakness in thighs and upper arms
Metabolism
-weight loss, appetite increased
Thermogenesis
-intolerance to heat
Smoking is an aggravating factor for Graves’ disease? (T/F)
True
What are the lab findings in Graves’ disease? What are the clinical implications?
- low TSH and high T4/3
- cardiac abnormalities - Hypercalcaemia
- increased bone turnover
- osteoporosis - Low WBC count
- TSH receptor antibody
What are the clinical signs of Graves’ disease?
Pretibial myxoderma
Thyroid acropachy (hands)
Eye disease
Throid bruit (rare)
Symmetrical, smooth goitre
What are the characteristics of Nodular thyroid disease?
V. high T4/3
Low TSH
Antibody negative
Asymmterical goitre
What is the treatment of Graves’ disease?
Dose titrate antithyroid drugs
What is an important side effect of Antithyroid drugs?
Agranulocytosis (low WBCs)
-infection in mouth and throat
Name the drugs used in hyperthyroidism treatment.
1st line: Carbimazole
1st line in pregnancy: Propulthiouracil (PTU)
Symtom relief: Propranolol (beta-blocker)
What is the treatment of relapsed Graves’ disease and nodular thyroid disease?
Radioiodine
List the causes of thyroiditis - inflammation of the thyroid.
Hashimoto’s
De Quervain’s: viral infection
Post-partum
Drug-induced
What drug can cause Thyroiditis?
Amiodarone
Lithium
What is Hashitoxicosis?
Transient period of thyroid hyperfunction in Hashimoto’s thyroiditis, before progressing to hypothyroidism
What are the 4 types of thyroid carcinomas? What cells are they derived from?
Papillary - follicular epithelium
Follicular -follicular epithelium
(Medullary) - C-cells
(Anaplastic) - epithelium
A benign single mass in the thyroid, surrounded by collagen, tightly packed with follicular cells describes a
Thyroid adenoma
What local effects can arise from a thyroid gland cancer?
hoarseness dysphagia dyspnoea persistent cough pain and swelling
