Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MRCOG - Part 2 > Thyroid Diseases In Pregnancy > Flashcards

Thyroid Diseases In Pregnancy Flashcards

1
Q

Most reliable test of thyroid gland in pregnancy

A

Free thyroxine

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

Tsh is produced from

A

Anterior pituitary

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

What is spillover syndrome

A

Hcg have the same alpha subunits as TSH-> so it mimics action pf tsh in pregnancy -> stimulate increase in thyroxine

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

Cause of worsen iodine deficiency in pregnancy

A

Due to:
- inc. GFR
- inc. uptake of iodine
- inc. trans placental tranfer

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

Hyperthyroidism TFT

A

Low TSH
High throxine

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

Complications of poorly controlled hyperthyroidism in pregnancy

A

Maternal
- thyroid storm
- CHF
- PE

Fetal
- FGR
- prematurity
- stillbirth

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

Signs of thyrotoxicosis in women

A
  • failure to gain weight despite of good appetite
  • tachycardia >100/min fails to slow despite of valsalva manoeavre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mode of action propthiouracil and carbimazole

A
  1. Block thyroid hormone synthesis
  2. Immunosuppressive effect-> reducing TSH receptors stimulating ABs (TSHR-AB: the hallmark of Graves’ disease)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sure sign of propylthiouracil and carbimazol

A

Agranulocytosis
(Severe neutropenia) that leads to sore throat

Do CBC

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

Management of hyperthyroidism in pregnancy

A

1st trimester: propylthiouracil
2nd,3rd: Carbimazol
Postpartum: propylthiouracil

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

Can we do thyroid surgery in pregancy

A

If needed

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

Indications of thyroid surgery in pregnancy

A
  1. Compression from a large goitre
  2. Suspicion of malignancy
  3. Failed antithyroid therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Do we give radioactive iodine in pregnancy ☢️

A

No it can crosses placenta and destroys the fetal thyroid

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

When to stop lactation before radioactive iodine

A

4 weeks before ttt

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

When to get pregnant after radioactive iodine

A

At least 6 months

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

If the male partner is taking radioactive iodine when to conceive

A

At least 4 months

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

Signs of thyrotoxicosis in neonates

A
  1. Tachycardia
  2. Excessive movements
  3. FGR, oligohydramnios & goitre
18
Q

Fetal graves disease can cause premature delivery that accompanied by

A

Craniosynostosis
Hydrops fetalis
IUFD
polyhydramnios
Obstructed labor from neck extension related to goitre

19
Q

HEG effect on TFTs

A

Transient hyperthyroidism

Suppressed TSH, high FT4

Over 60% of pregnancy

20
Q

Iodine deficiency effect on neonate

A

Neonatal cretinism is leading preventable cause of mental handicap 2-10%

21
Q

Normal TSH levels

22
Q

Precoception TSH taget level for optimum fertility

23
Q

Hypothyroidism effect on menstruation

A
  1. Oligomenorrhea
  2. Menorrhagia
  3. Amneorreah
    In some cases anovulation

Heavy less frequent menses

24
Q

Hyperthyroidism effect on menstruation

A
  1. Polymenorrhea
  2. Hypomenorrhea

Light frequent menstruation

25
Subclincial hypothyroidism TFT
High TSH Low FT3,FT4
26
Do OHSS will lead to thyroid disease
Increase E2 leads to inc TBG-> temporary hypothyroidism
27
Most common cause of hypothyroidism in women of reproductive age
Autoimmune thyroid disease AITD
28
Conplications of AITD
1. Lower fertilization rate 2. Poor embryo quality 3. Precursor to overt thyroid dis
29
When to reassess thyroid levels after levothyroxine ttt
After 6 weeks of ttt
30
Do thyroid disease associated with miscarriage
Yes but yet routine screening in asymptomatic women is not recommended
31
Do levothyroxine decreases miscarriage in women with subclinical hypothyroidism
Yes
32
Most cause of hyperthyroidism in pregnancy
Graves’ disease 1%
33
How to diffrentiate between hyperthyroidism and gestational hyperthyroidism
Free T4 is generally raised, but TSH receptors antibodies are positive in graves
34
How Gestational hyperthyroidism treated
Only support ttt, as FT4 levels tend to return to normal in the 2nd trimester
35
Best antithyorioid in pregnancy
Propylthiouracil But needs to be changed in 2nd trimester to prevent hepatotoxicity
36
Do AITD in euothyroid women is predictive of thyroid disease
Yes they have lymphocytic infiltration of the thyroid gland so may develop hypothyroidism in pregnancy
37
Do we give levothyroxine to euthyroid women with AITD
Not routinely recommended
38
Normal TSH levels with pregnancu
1st -2nd: 0.2 - 3 mU/l 3rd: 0.3-3 mU/l
39
LT4 dosage adjustment in pregnancy in women with hypothyroidism
Women with overt or subclinical hypothyroidism-> the dose must increase initially >25ug daily once pregnancy is confirmed TFT every 4-6 weeks Optimal level: 0.5-2.5 mU/l
40
Monitoring of fetuses and neonates of women with AITD
Fetal growth and heart rate for the rare risk of fetal hyperthyroidism Neonatal review after delivery for the small risk of neonatal hyperthyroidism
41
TFTs assessment in euthyroid women with AITD
Every 4 weeks in early pregnancy At least once bet 26-32 w

MRCOG - Part 2 (60 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions