THYROID DISEASES Flashcards

1
Q

what antibodies are found in almost all patients with autoimmune hypothyroidism

A

Thyroglobulin and Thyroid peroxidase (TPO)

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2
Q

what antibodies are the cause of graves diseaes

A

Thyroid stimulating antibodies

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3
Q

What is the greatest risk factor for Predisposition to thyroid autoimmunity

A

being Female

-also post partum

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4
Q

what gene could predispose you to thyroid autoimmunity

A

HLA-DR3

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5
Q

what are the 3 group factors that cause thyroid autoimmunity

A

Genes
Endogenous
Environment

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6
Q

what are some Autoimmune diseases associated with thyroid autoimmunity (name 5)

A

** Type 1 diabetes mellitus
**
Addison’s disease
* Pernicious anaemia
** Vitiligo
**
Alopecia areata
* Coeliac disease/ dermatitis herpetiformis
* Chronic active hepatitis
* Rheumatoid arthritis/ SLE/ Sjogren’s syndrome
* Myasthenia gravis (Graves’ disease)

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7
Q

what causes Thyroid associated ophthalmopathy in graves disease

A

-**Swelling in extraocular muscles **is likely due to an autoantigen in the extraocular muscle that cross reacts with, or is identical to, a thyroid autoantigen

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8
Q

what is a Goiter

A

lump or swelling at the front of the neck caused by a swollen thyroid

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9
Q

Define HYPERTHYROIDISM and list 3 mechanisms for increased levels:

A
  • Excess of thyroid hormones in blooda. overproduction thyroid hormone
    b. leakage of preformed hormone from
    thyroid
    c. ingestion of excess thyroid hormone
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10
Q

What are common causes of hyperthyroidism

A
  • Graves’ disease (75- 80% of all cases)
  • Toxic multinodular goitre
  • Toxic adenoma
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11
Q

List some drugs that could induce hyperthyroidism

A
  • Iodine
  • Amiodarone
  • Lithium
  • Radiocontrast agents (contains large doises of iodine)
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12
Q

List CLINICAL FEATURES of hyperthyroidism

A

Weight loss
Tachycardia
Anxiety
Tremor
Hyperphagia
Heat intolerance
sweating
Diarrhoea
Lid lag + stare
Menstrual disturbance

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13
Q

what condition matches the following** clinical features:**

  • Diffuse goitre
  • Thyroid eye disease (infiltrative)
  • Pretibial myxoedema
  • Acropachy
A

Graves

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14
Q

Which antibodies are responsible for graves

A

**Thyroid-stimulating autoantibodies **(TSAb’s) that activate the thyrotropin receptor (TSHR).

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15
Q

what is the name of these symptoms and the hyperthyyroid condition
Image

A

Thyroid eye disease - Graves

(some will have forwards protrusion and others posterior (compressing optic nerve))

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16
Q

how would you investigate hyperthyroidism

A

Thyroid function tests = suppressed TSG, Increased free T3 and T4

-supporting tests - Thyroid antibodies: TPO, Tg, TRAb
Isotope uptake scan

17
Q

what is the treatment for graves

A
  • carbimazol
  • surgery
  • Radioiodin 131I
  • propythiouracil used in perngnacy as carbimazolis highly tetragenic
18
Q

what is a possible side effect of carbimazol (Thionamides)

A

agranulocytosis

19
Q
A
19
Q
A
20
Q

what is hypothyroidism and the different types

A
  • **abnormally low thyroid hormones
  • **3 typesPRIMARY (>99%)
    - absence / dysfunction thyroid gland
    - most cases due to Hashimoto’s thyroiditisSECONDARY / TERTIARY
    - pituitary / hypothalamic dysfunction
21
Q

what are the common symptoms of hypothyroidism

A

Fatigue
Weight gain /difficulty loosing weight
cold
bradychardic
dry skin
muscles cramps
odemema
preorbital oedema
constipation

22
Q
A
23
Q
A
24
Q

How would you investigate secondary hypothyroidism

A

Reduced TSH, T3 and T4

25
Q

How is hypothyroidism treated

A

Treatment of choice - synthetic L-thyroxine (T4)

26
Q

what is a complication of graves

A

thyroid sorm/thyrotoxosis

27
Q

what treatment for hypothyroidism

A

levothyroxine