Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENDO (Endocrinology) > Thyroid Disease - Hyperthyroidism > Flashcards

Thyroid Disease - Hyperthyroidism Flashcards

1
Q

Aetiology of Hyperthyroidism (4).

A
  1. Grave’s Disease (commonest).
  2. Toxic Multinodular Goitre (2nd commonest).
  3. Solitary Toxic Thyroid Nodule (Benign Adenoma - Surgical Removal).
  4. Thyroiditis (e.g. De-Quervain’s, Hashimoto’s, Post-Partum, Drug-Induced- Amiodarone).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Grave’s Disease?

A

An autoimmune condition where the TSH receptor antibodies cause a primary hyperthyroidism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathophysiology of Grave’s Disease.

A

TSH Receptor Antibodies mimic TSH and stimulate the TSH receptors on the Thyroid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Unique Clinical Features of Grave’s Disease (5).

A

Due to TSH Receptor Antibodies :
1. Diffuse Goitre (Without Nodules).
2. Grave’s Eye Disease.
3. Bilateral Exophthalmos.
4. Pretibial Myxoedema.
5. Thyroid Acropachy (Digital Clubbing, Soft Tissue Swelling in Hands and Feet, Periosteal New Bone Formation).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Pretibial Myxoedema?

A

A dermatological condition where there are deposits of mucin under the skin in the pre-tibial area, giving a discoloured, waxy, oedematous appearance to the skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What ocular signs are seen in Grave’s Disease? (3)

A
  1. Exophthalmos.
  2. Ophthalmoplegia.
  3. Periorbital Oedema.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Plummer’s Disease?

A

Toxic Multinodular Goitre - nodules develop on the thyroid gland that act independently of the normal feedback system and continuously produce excessive Thyroid hormone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management of Choice of Toxic Multinodular Goitre.

A

Radioiodine Therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical Presentation of De Quervain’s Thyroiditis (4).

A

Presentation of Viral Infection with :
1. Fever.
2. Neck Pain & Tenderness.
3. Dysphagia.
4. Features of Hyperthyroidism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pathophysiology of De Quervain’s Thyroiditis (2).

A
  1. Hyperthyroid Phase.
  2. Hypothyroid Phase (Negative Feedback).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management of De Quervain’s Thyroiditis (3).

A
  1. Self-Limiting : Supportive.
  2. Pain and Inflammation : NSAIDs.
  3. Symptomatic : B-Blockers.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical Features of Hyperthyroidism (7).

A
  1. Anxiety and Irritability.
  2. Sweating and Heat Intolerance.
  3. Tachycardia & Palpitations & High-Output HF.
  4. Weight Loss.
  5. Fatigue.
  6. Frequent Loose Stools.
  7. Sexual Dysfunction.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antibodies of Hyperthyroidism (3).

A
  1. anti-TPO (Thyroid Peroxidase) Antibodies : Grave’s Disease and Hashimoto’s Thyroiditis.
  2. anti-Thyroglobulin Antibodies : Grave’s Disease, Hashimoto’s Thyroiditis, Thyroid Cancer.
  3. TSH Receptor Antibodies : Grave’s Disease.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Imaging Investigations of Hyperthyroidism (2).

A
  1. US - Diagnose Thyroid Nodules and Distinguish Between Cystic and Solid Nodules.
  2. Radioisotope Scans.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens in a Radioisotope Scan?

A
  1. Oral/IV Radioactive Iodine Uptake by Cells.
  2. Faster Uptake = More Active Thyroid Cells.
  3. Gamma Camera Detects Gamma Rays Emitted from Radioactive Iodine.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Results of Radioisotope Scan (3).

A
  1. Diffuse Homogenous High Uptake - Grave’s Disease.
  2. Focal Patchy High Uptake - Toxic Multinodular Goitre and Adenoma.
  3. Cold Area (Abnormally Low Uptake) - Thyroid Cancer.
17
Q

What is Thyroid Storm?

A

A Thyrotoxic Storm - severe presentation of hyperthyroidism.

18
Q

Clinical Features of Thyroid Storm (4).

A
  1. Pyrexia (>38.5).
  2. Tachycardia, HTN, HF.
  3. Delirium and Agitation.
  4. Nausea and Vomiting.
19
Q

Management of Thyroid Storm (3).

A
  1. Admission & Supportive Care : Fluid Resuscitation.
  2. Treatment of Underlying Precipitating Event + Anti-thyroid Drugs.
  3. IV Propanolol, IV Digoxin, Propylthiouracil (NG Tube) + Lugol’s Iodine 6 Hours Later, Prednisolone/Hydrocortisone.
20
Q

Precipitating Events in a Thyroid Storm (4).

A
  1. Thyroid/Non-Thyroidal Surgery.
  2. Trauma.
  3. Infection.
  4. Acute Iodine Load (e.g. CT Contrast Media).
21
Q

Management of Hyperthyroidism (5).

A
  1. Carbimazole (1st Line).
  2. Propylthiouracil (2nd Line - Risk of Severe Hepatic Reactions).
  3. Radioactive Iodine.
  4. B-Blockers (Symptomatic).
  5. Surgery.
22
Q

Dosing and Administration of Carbimazole (3B).

A
  1. Normalises Thyroid Function after 4-8 Weeks.
  2. Continue on Maintenance Carbimazole.
    3A. Titration Block (Carefully titrate dose to maintain normal levels).
    3B. Block and Replace (Block all production and Levothyroxine is Titrated to Effect).
23
Q

How long is management required with Carbimazole?

A

Complete Remission usually within 18 months of treatment.

24
Q

Mechanism of Action of Carbimazole.

A

Blocks TPO from coupling and iodinating Tyrosine residues on Thyroglobulin which reduces Thyroid Hormone production.

25
Q

Adverse Effects of Carbimazole.

A

Agranulocytosis.

26
Q

Contraindication of Carbimazole.

A

Early Pregnancy (usable in later pregnancy) - use Propylthiouracil instead.

27
Q

Dose and Administration of Radioactive Iodine (3).

A
  1. Drink a single dose of Radioactive Iodine (taken up by Thyroid and emitted radiation destroys a proportion of cells).
  2. Reduction in functioning cells = decrease in Thyroid Hormone production.
  3. Remission can take 6 months - patient can be left hypothyroid afterwards (requiring Levothyroxine Replacement).
28
Q

Important Considerations of Radioactive Iodine (4).

A
  1. No Active Pregnancy or Recent (6 Months) Pregnancy.
  2. Avoid Close Contact with Kids and Pregnant Women for 3 Weeks (Dose-Dependent).
  3. Limit Contact with Anyone for a Few Days.
  4. Thyroid Eye Disease - Relative Contraindication.
29
Q

Which B-Blocker is useful in Hyperthyroidism?

A

Propanolol - non-selectively blocks adrenergic activity.

30
Q

Surgery to Hyperthyroidism (3).

A
  1. Definitive Option to Remove the Whole Thyroid/Toxic Nodule.
  2. Stop Production of Thyroid Hormone.
  3. Hypothyroid Post-Thyroidectomy = Requirement for Levothyroxine Replacement for Life.
31
Q

Complications of Thyroidectomy (4).

A
  1. Hypoparathyroidism.
  2. Hypocalcaemia.
  3. Laryngeal Nerve Damage.
  4. Bleeding.

ENDO (Endocrinology) (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions