Brainscape's Knowledge GenomeTM

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


See full index

MBChB IV Endocrinology > Thyroid diseases > Flashcards

Thyroid diseases Flashcards

1
Q

Symptoms of hyperthyroidism

A 
Hyperactivity
Irritability
Dysphoria
Heat intolerance
Sweating
Palpitations
Fatigue
Weakness
Weight loss w/ increased appetite
Diarrhoea
Polyuria
Oligomenorrhoea
Loss of libido
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs of hyperthyroidism

A 
Tachycardia
Afib
Tremor
Goiter
Warm, moist skin
Proximal mm weakness
Lid retraction
Lid lag
Gynecomastia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name common causes of hyperthyroidism

A

Grave’s disease
Toxic multinodular goiter
Autonomously functioning nodule

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

Name rare causes of hyperthyroidism

A 
Thyroiditis
Causes of destruction
Thyrotoxicosis factita
Iodine excess
Struma ovarii
Secondary (TSH, BHCG)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is Jod-Basedow phenomenon linked to hyperthyroidism?

A

Excess of iodine -> hyperthyroidism

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

What is Grave’s disease?

A

Autoimmune disorder w/ antibodies against TSH receptor w/ intrinsic activity
F>M

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which disease is responsible for 60-80% of thyrotoxicosis?

A

Grave’s disease

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

Eye signs of Grave’s disease

A 
NOSPECS
No signs or symptoms
Only signs, no symptoms  (lid lag/retraction)
Soft tissue involvement (periorbital oedema)
Proptosis >22mm 
Extraocular mm involvement (diplopia)
Corneal involvement (keratitis)
Sight loss (optic nn compression)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which test do you perform to measure proptosis?

A

Hertl’s test

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

Signs other than eye signs of Grave’s disease

A

Pretibial myxoedema
Thyroid acropachy
Onycholysis
Thyroid enlargement w/ audible bruit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you diagnose Grave’s disease?

A

Low TSH, high free T4
Thyroid autoantibodies (TPO, antithyroglobulin)
Anti-TSH receptor antibodies
Nucleur thyroid scintigraphy w/ I123, Te99 - increased uptake of radiomarker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the treatment of Grave’s disease?

A 
Reduce TH production
Reduce amount of thyroid tissue
- Antithyroid drugs (propylthiouracil, carbimazole)
- Radioiodine 
- Subtotal thyroidectomy 
Symptomatic treatment
- Propanolol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is radioiodine contraindicated in Grave’s disease?

A

Severe Grave’s ophthalmopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Indications for subtotal thyroidectomy?

A

Relapse after antithyroid therapy
Pregnancy
Young age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the pathogenic mechanism of Grave’s disease in hyperthyroidism?

A

TSH receptor stimulating antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the pathogenic mechanism of toxic multinodular goiter in hyperthyroidism?

A

Autonomous hyperfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the pathogenic mechanism of follicular adenoma in hyperthyroidism?

A

Autonomous hyperfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the pathogenic mechanism of pituitary adenoma in hyperthyroidism?

A

TSH hypersecretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the pathogenic mechanism of pituitary insensitivity in hyperthyroidism?

A

Thyroid hormone resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the pathogenic mechanism of hypothalamic disease in hyperthyroidism?

A

Excess TRH production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the pathogenic mechanism of germ cell tumours in hyperthyroidism?

A

HCG stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the pathogenic mechanism of struma ovarii in hyperthyroidism?

A

Functioning thyroid elements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the pathogenic mechanism of metastatic follicular thyroid carcinoma in hyperthyroidism?

A

Functioning metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the pathogenic mechanism of lymphocytic thyroiditis in hyperthyroidism?

A

Release of stored hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the pathogenic mechanism of granulomatous thyroiditis in hyperthyroidism?

A

Release of stored hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the pathogenic mechanism of Hashimoto’s thyroiditis in hyperthyroidism?

A

Transient release of stored hormone

27
Q

What is the pathogenic mechanism of thyrotoxicosis medicamentosa in hyperthyroidism?

A

Ingestion of excessive exogenous thyroid hormone

28
Q

What is the pathogenic mechanism of thyrotoxicosis factitia in hyperthyroidism?

A

Ingestion of excessive exogenous thyroid hormone

29
Q

What is the pathogenic mechanism of amiodarone in hyperthyroidism?

A

Excess iodine and/or thyroiditis

30
Q

What is the pathogenic mechanism of interferon alpha in hyperthyroidism?

A

Thyroiditis

31
Q

What is the pathogenic mechanism of interferon alpha in hyperthyroidism?

A

Thyroiditis

32
Q

Symptomsof hypothyroidism

A 
Tiredness
Weakness
Dry skin
Feeling cold
Hair loss
Difficulty in concentrating
Poor memory
Constipation
Weight gain w/ poor appetite
Hoarse voice
Menorrhagia
Oligo/amenorrhoea
Parasthesias
Impaired hearing
33
Q

Signs of hypothyroidism

A 
Dry skin
Cool extremities
Puffy face, hands + feet
Delayed tendon reflex relaxation
Carpal tunnel syndrome
Bradycardia
Diffuse alopecia
Serous cavity effusions
34
Q

Name causes of hypothyroidism

A 
Autoimmune 
- Hashimoto's atrophic thyroiditis
Iatrogenic 
- I123 treatment
- thyroidectomy
- external irradiation of neck
Drugs
- iodine excess
- lithium
- antithyroid drugs
Iodine deficiency
Infiltrative thyroid disorders
- amyloidosis
- sarcoidosis
- haemochromatosis
- scleroderma
35
Q

Name causes of hypothyroidism

A 
Autoimmune 
- Hashimoto's atrophic thyroiditis
Iatrogenic 
- I123 treatment
- thyroidectomy
- external irradiation of neck
Drugs
- iodine excess
- lithium
- antithyroid drugs
Iodine deficiency
Infiltrative thyroid disorders
- amyloidosis
- sarcoidosis
- haemochromatosis
- scleroderma
36
Q

Lab investigations of hypothyroidism

A 
High TSH, low free T4
Antithyroid antibodies (anti-TPO)
Increased S-CK
Increased S-Chol
Increased S-triglyceride
37
Q

What will you see on bloods in hypothyroidism?

A

Normochromic/macrocytic anemia

38
Q

What will you see on ECG in hypothyroidism?

A

Bradycardia w/ small QRS complexes

39
Q

Thyroid U/S has a lot of value in investigating hypothyroidism
True or false?

A

False

Only show atrophy

40
Q

Thyroid scintigraphy has a lot of value in investigating hypothyroidism
True or false?

A

False

Only show atrophy

41
Q

Treatment of hypothyroidism?

A

Levothyroxine

  • 1.5ug/kg/day if no residual thyroid function
  • 12.5-25ug/day >60yo esp w/ CAD
  • 50-100ug/day is pt <60yo w/o cardiac disease
42
Q

What is the dose of levothyroxine adjusted according to?

A

TSH levels

43
Q

Subclinical hypothyroidism

A

High TSH, normal free T4

44
Q

When do you treat subclinical hypothyroidism?

A 
Any of the following:
Antibody +
Prev treatment for Grave's
Other organ specific AI disease
TSH > 10
45
Q

How do you treat subclinical hypothyroidism?

A

Thyroxine treatment

46
Q

When do you not treat subclinical hypothyroidism

A 
None of the following:
Antibody +
Prev treatment for Grave's
Other organ specific AI disease
TSH > 10
47
Q

How do you monitor subclinical hypothyroidism?

A

6-12 monthly TSH measurement

48
Q

What do you do if a patient with subclinical hypothyroidism is symptomatic?

A

Trial of thyroxine

49
Q

What is euthyroid sick syndrome?

A

Occurs in patients w/ systemic disease/starvation
Decreased peripheral conversion of T4 -> T3
Reduced TSH release
Loss of pulsatile secretion
Low T3 low T4 low TSH

50
Q

Why should you not bother with TFTs in an ICU patient?

A

Euthyroid sick syndrome

51
Q

What is acute thyroiditis?

A

Rare
Painful thyroid gland due to suppurative infection of the thyroid
Elevated ESR
Normal thyroid function

52
Q

Another name for subacute thyroiditis?

A

De Quervain’s thyroiditis

Granulomatous thyroiditis

53
Q

What is the major cause of subacute thyroiditis?

A

Viral

  • mumps
  • coxsackie
  • influenza
  • adeno
  • echo
54
Q

Name causes of acute thyroiditis

A 
Bacterial
- strep
- staph
Fungal
- aspergillus
- candida
- histoplasma
- pneumocystic
Radiation thyroiditis
Amiodarone
55
Q

What is subacute thyroiditis?

A

Viral cause
3 phases from painful enlarged thyroid -> complete resolution
Affects middle aged women

56
Q

Treatment for subacute thyroiditis?

A

NSAIDs

Glucocorticoids

57
Q

What is postpartum thyroiditis

A 
AKA silent thyroiditis
No thyroid tenderness
3-6mo after pregnancy
3 phases: hyper-> hypo -> resolution lasting 12-20 weeks
Normal ESR
TPO Abs present
No treatment necessary
58
Q

What is Hashimoto’s thyroiditis?

A 
Chronic autoimmune
Goiter -> destruction of thyroid
Insidious onset and progression
Pain is rare
TPO Abs present
59
Q

What is the most common cause of hypothyroidism?

A

Hashimoto’s thyroiditis

60
Q

What is Reidel’s chronic thyroiditis?

A 
Rare
Middle aged women
Insidious as painless
Symptoms due to compression when dense fibrosis developed
No thyroid function impairment
61
Q

Which drugs decrease thyroid protein binding concentrations?

A

Glucocorticoids
Androgens
Danazol

62
Q

Which drugs increased thyroid protein binding concentrations?

A

Oestrogens
Heroin
Clofibrate

63
Q

Give examples of conditions that cause increased thyroid protein binding concentrations?

A

Pregnancy
Chronic hepatitis
Acute intermittent porphyria
Oestrogen producing proteins

64
Q

Give examples of conditions that cause decreased thyroid protein binding concentrations?

A 
Acromegaly
Nephrotic syndrome
Hypoproteinaemia
Liver cirrhosis
Testosterone producing tumours

MBChB IV Endocrinology (8 decks)

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