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PY7020 REVISION > Thyroid Disorders > Flashcards

Thyroid Disorders Flashcards

1
Q

What 2 hormones does the thyroid gland secrete?

A

Thyroxine T4
Active T3

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2
Q

What happens to TSH release in hyper & hypothyroidism?

A

Remember them as opposites

Hypothyroidism = HIGH TSH
Hyperthyroidism = LOW TSH

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3
Q

What 2 substances are always tested in a thyroid function test (TFT)?

A

TSH & T4

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4
Q

How long does it take for TSH levels to adjust after therapy?

A

Up to 8 weeks

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5
Q

In hyperthyroidism, is T4 or T3 higher?

A

T3

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6
Q

Why aren’t TSH levels always high in hypothyroidism?

A

Because TSH levels take time to adjust

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7
Q

What substance does synthesising thyroxine require?

A

Iodine

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8
Q

What is thyroiditis?

A

It is an inflammation of the thyroid gland due to e.g. a virus, drug-induced, autoimmune or post-partum

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9
Q

What are the symptoms of viral thyroiditis?

A

Flu like symptoms + hyperthyroidism, then hypothyroidism

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10
Q

What treatment is used for viral thyroiditis?

A

NSAIDs + short course of steroids + b blockers

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11
Q

What drugs interact with the thyroid gland?

A

Lithium - hypo
Amiodarone - hyper or hypo
Iodide - hyper
Glucocorticoids/dopamine - hyper
Aspirin
Anticonvulsants

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12
Q

Why are the symptoms of hypothyroidism?

A

Remember everything as SLOW

Constipation
Weight gain
Goitre
Coldness
Bradycardia
Muscle stiffness
Lethargy

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13
Q

What can cause hypothyroidism?

A

Hashimoto’s disease
Drug induced
Radioiodide/surgical treatment of hyperthyroidism

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14
Q

What is the treatment of hypothyroidism?

A

Levothyroxine dose ranging from 25-200mcg daily

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15
Q

When are TFT’s assessed in hypothyroidism?

A

After 6 weeks of treatment to allow TSH to stabilise, then every 6-12months

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16
Q

What drug is used in severe hypothyroidism (include dose)?

A

Liothyronine sodium 10-20mcg oral or IV

17
Q

What are the symptoms of hyperthyroidism?

A

Remember everything as FAST

Diarrhoea
Increased appetite
Weight loss
Goitre
Tachycardia/palpitations
Irritability

18
Q

Why are b-blockers given in hyperthyroidism?

A

To control the symptoms of tremor/palpitations/tachycardia

19
Q

Why should you be careful when giving b-blockers to a diabetic patient?

A

Because b-blockers can mask hypoglycaemic symptoms.

20
Q

What causes hyperthyroidism?

A

Graves Disease - antibodies looking like TSH bind to thyroid gland and secrete more T3/T4

21
Q

What is the mode of action of carbimazole?

A

It prevents the coupling of tyrosine and iodine so reduced T3 and T4 levels

22
Q

How long is carbimazole used for in hyperthyroidism?

A

12-18 months

23
Q

What side effect should patients taking carbimazole report immediately?

A

Sore throat/fever/infections as carbimazole can cause agranulocytosis

24
Q

Why is levothyroxine & carbimazole sometimes given together?

A

To balance hypo & hyperthyroidism states (avoiding under/overtreatment)

25
Q

What risk can increase if radioactive iodine is used as treatment for hyperthyroidism?

A

Hypothyroidism

26
Q

What are examples of some b-blockers used in hyperthyroidism?

A

Nadolol
Propranolol
Metoprolol

27
Q

What MUST be present before surgery in hyperthyroidism?

A

Normal thyroid function to reduce palpitations/tachycardia during surgery
B-blockers are given to prevent this

28
Q

Why is unactive T4 sometimes given before surgery?

A

To reduce the bleeding risk associated with b-blockers

29
Q

What should replace anti-thyroid drugs 10-14 days before a thyroidectomy?

A

Potassium iodide to inhibit thyroid release

30
Q

What complications can arise from a thyroidectomy?

A

Hypocalcaemia
Hypothyroidism
Hypoparathyroidism

31
Q

How often should TFT’s be measured after a thyroidectomy?

A

At 2 and 6 months, then annually.

32
Q

How often should TFTs of anti-thyroid drugs be measured?

A

After 8 weeks of treatment, then every 3 months for 1 year, then annually

33
Q

What can cause a thyroid crisis?

A

Infection
Stress
Unprepared patient before surgery

34
Q

What is the management of a thyroid crisis?

A

High dose carbimazole
Propranolol
Dexamethasone
Iodine T4

PY7020 REVISION (42 decks)

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