Thyroid disorder

Question 1

Carbimazole SEs

Answer 1

• Agranucytosis
• Acute pancreatitis

Question 2

PTU SEs

Answer 2

• Agranucytosis
• severe liver reactions

Question 3

Severe complication of Hypothyroidism

Answer 3

Myxoedema coma

Question 4

Myxoedema coma Sx

Answer 4

• Periorbital oedema
• Pitting oedema to the ankles
• Confusion
• Loss of consciousness

Question 5

Hypothyroid Mx

Answer 5

CKS guidelines: 1.6mcg per kg to the nearest 25mcg (< 65 + NO CVD)
- For < 65: Initiate at 50mcg
- For > 65/CVD: Initate at 25mcg

Question 6

TFT monitoring after initiation of LT4 Tx

Answer 6

6 weeks until stable

Question 7

TFT monitoring for people on LT4

Answer 7

TFTs every 3 months until the level has stabilised (2 similar measurements within the reference range 3 months apart), and then once a year

Question 8

When to offer LT4 for Subclinical Hypothyroid

Answer 8

• TSH >10
• Normal FT4 on 2 occasions 3/12 apart

Question 9

When to offer 6-month trial LT4 for Subclinical Hypothyroid

Answer 9

• < 65 years
• TSH raised but < 10
• Normal FT4 on 2 occasions 3/12 apart
• Symptomatic

Question 10

How to take LT4

Answer 10

LT4 should be taken on an empty stomach 30min-60mins before food, caffeinated drink, or other meds

Question 11

Grave’s specific auto-Abs

Answer 11

Anti-TRAbs: Anti TSH Receptor Antibodies

Question 12

Hashioto’s specific auto-Abs

Answer 12

• Anti-TPOs
• Auto-TGs

Question 13

TED complication

Answer 13

Optic neuropathy

Question 14

TED Mx

Answer 14

Steroids

Question 15

Hyperthyroid Sx relief Mx

Answer 15

Propranolol