Thyroid Disease Flashcards
what is grave’s disease?
auto antibodies stimulating the TSH receptor
what can hyperthyroidism be due to?
Graves disease, toxic multi-nodular goitre, toxic adenoma, pituitary tumour
what are the signs of hyperthyroidism?
warm most skin, tachycardia and atrial fibrillation, increased blood pressure and heart failure, tremor and hyperreflexia, eyelid retraction and lid lag
what are the symptoms of hyperthyroidism?
hot and excess sweating, weight loss, diarrhoea, palpitations, muscle weakness, irritable, mainc, anxious
what is the clinical presentation of Grave’s disease?
diffuse goitre, opthalmopthy (scleral injection, proptosis, periorbital oedema), conjunctival oedema (chemosis)
what is primary hypothyroidism caused by?
autoimmune (Hashimoto’s) thyroiditis , idiopathic atrophy, radioiodine treatment/thyroidectomy surgery, iodine deficiency, drugs, congenital
what is secondary hypothyroidism caused by?
hypothalamic/pituitary disease
what are the signs of hypothyroidism?
dry coarse skin, bradycardia, hyperlipidaemia, psychiatric or confusion, goitre, delayed reflexes
what are the symptoms of hypothyroidism?
tired, cold intolerance, weight gain, hoarse voice, goitre, puffed face, angina, slow, hair loss
what is hypothyroidism?
reduced metabolism
what is hyperthyroidism?
increased metabolism
who does Hashimoto’s syndrome present in?
middle aged and elderly women
what are the presenting features of Hashimoto’s syndrome?
goitre, hypothyroid features
what is the cause of idiopathic atrophy?
likely autoimmune - lymphocyte infiltrate, associated with organ specific autoimmune disease
what investigations are used for thyroid diseases?
blood, imaging, tissue
what blood components are looked for when investigating thyroid disease?
TSH, T3 and T4
what are the hormone levels of pituitary hyperthyroidism?
raised TSH, raised T3
what are the hormone levels of graves/adenoma hyperthyroidism?
low TSH, raised T3
what are the hormone levels of pituitary hypothyroidism?
low TSH, low T4
what are the hormone levels of gland failure hypothyroidism?
high TSH, low T4
what is used to treat hyperthyroidism?
carbimazole, b-blockers, radioiodine, surgery (partial thyroidectomy)
what is used to treat hypothyroidism?
T4 tablets (thyroxine) where you increase the dose slowly
what are the types of thyroid enlargement?
goitre and solitary nodule enlargement
what is goitre and what is it caused by?
diffuse enlargement of the thyroid gland, iodine deficient, can be drug related
what is solitary nodule enlargement caused by?
adenoma, carcinoma, cyst formation
what is thyroid cancer accompanied by?
thyroid swelling
what are the dental aspects of hyperthyroidism?
pain anxiety and psychiatric problems, caution for treatment until controlled
what are the dental aspects of hypothyroidism?
avoid the use of sedatives if severe
