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Endocrinology > Thyroid Disorders > Flashcards

Thyroid Disorders Flashcards

1
Q

What are the possible causes of primary hypothyroidism?

A

Autoimmune (Hashimoto’s thyroiditis)
Iodine deficiency
Inborn errors
Goitrogenic drugs

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2
Q

What blood results will be expected in primary hypothyroidism?

A

Low T4

High TSH

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3
Q

What syndrome can cause secondary hypothyroidism?

A

Sheehan’s syndrome

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4
Q

What blood results will be expected in secondary hypothyroidism?

A

Low T4

Low TSH

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5
Q

What are the potential causes of hypothyroidism?

A

Hypopituitarism
Thyroidectomy
Post-radioactive iodine ablation of the thyroid
Congenital hypothyroidism
Autoimmune (postpartum, silent, Hashimoto’s)

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6
Q

Hashimoto’s thyroiditis is more common in men. T/F?

A

False it is more common in women

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7
Q

What features in the child can be caused by maternal thyroid disease during pregnancy?

A 
Cretinism
Coarse facial features 
Large fontanelles
Macroglossia
Umbilical hernia
Mottled dry skin
Developmental delay
Pallor
Myxoedema
Goiter
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8
Q

What are the possible causes of congenital hypothyroidism?

A

Thyroid dysgenesis

Dyshormogenesis

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9
Q

What are the symptoms of hypothyroidism?

A 
Myxoedema
Slowed physical and mental activity
Fatigue
Cold intolerance
Periorbital oedema
Hoarseness
Coarsening of skin and facial features
Cardiomegaly
Effusions
Hair loss
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10
Q

How is hypothyroidism treated?

A

75-150mcg per day of levothyroxine

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11
Q

Why might patients have problems with absorption of levothyroxine?

A

Coeliac disease

Other medications PPIs and iron

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12
Q

What are the expected blood results in primary hyperthyroidism?

A

Low TSH

High T4

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13
Q

What are the expected blood results in secondary hyperthyroidism?

A

High TSH and T4

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14
Q

What are the possible causes of hyperthyroidism?

A 
Autoimmune (Grave's. disease)
Toxic adenoma
Multinodular goitre
Thyroiditis
Excess administration of thyroxine
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15
Q

What factors can contribute to the development of Grave’s disease?

A

Genetic susceptibility
Environemental factors e.g. iodine and tobacco smoke
Immune modulating treatments e.g. interferon or alemtuzemab

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16
Q

What is the only cause of hyperthyroidism in which a bruit in the thyroid can be heard?

A

Grave’s disease

17
Q

What phenomenon results in iodine induced hyperthyroidism?

A

Job

18
Q

What phenomenon results in iodine induced hypothyroidism?

A

Wolff Chaikoff effect

19
Q

How is type one amiodarone thyroid disease treated?

A

Carbimazole

20
Q

How is type two amiodarone thyroid disease treated?

A

Glucocorticoids

21
Q

What are the symptoms of hyperthyroidism?

A 
Weight loss
Tremor
Heat intolerance
Diarrhoea
Tachycardia
Hypertension
Palpitations
Sweating 
Goitre
22
Q

What signs/symptoms are seen in thyroid eye disease?

A 
Lid lag
Periorbital oedema
Proptosis
Diplopia
Nerve compression
23
Q

How can thyroid eye disease be managed?

A

Eye drops
Taping the eyes shut at night
Use of protective glasses

24
Q

What symptom in thyroid eye disease would indicate optic nerve compression (an ophthalmological emergency)?

A

Changes in colour vision

25
Q

What is the treatment of hyperthyroidism?

A

Propranolol (beta blockers) for symptomatic reflied
Carbimazole or propylthiouracil to decrease production of thyroid hormone
Definitive treatment with radioactive iodine or surgery

26
Q

Most thyroid nodules are benign. T/F?

A

True

27
Q

How can thyroid nodules be investigated?

A

Imaging

Ultrasound guided fine needle biopsy

28
Q

How are. follicular cell. tumours of the thyroid treated?

A

Surgery

Therapeutic radio iodine

29
Q

List the different types of thyroid cancer

A

Follicular tumour - benign adenomas, papillary cancers, follicular cancer, anaplastic cancer, poorly differentiated thyroid cancer
Thyroid C cell tumours - medullary cancers

30
Q

What is the most sensitive marker of thyroid dysfunction?

A

TSH

31
Q

Describe what is meant by the term ‘sick euthyroidism’.

A

In very unwell patients a pattern of ‘sick euthyroidism’ is often seen where there are low TSH, free T3 and T4 levels. These tests should be repeated when the patient has recovered and will usually have returned to normal values

32
Q

If a diffuse uptake with suppression of background activity is seen on a nuclear imaging scan of the thyroid then this indicates…?

A

Graves disease

33
Q

If an irregular uptake is seen on a nuclear imaging scan of the thyroid then this indicates…?

A

Multinodular goitre

34
Q

If a hot nodule is seen on a nuclear imaging scan of the thyroid then this indicates…?

A

Toxic adenoma

35
Q

If reduced uptake is seen on a nuclear imaging scan of the thyroid then this indicates…?

A

Thyroiditis

36
Q

When is radioactive iodine treatment contraindicated?

A

Pregnancy
Breast feeding
Active thyroid eye disease

37
Q

What serious side effect of carbimzaole and propylthiouracil should patients be warned about?

A

Agranulocytosis

38
Q

In what patients would you start on a low dose of levothyroxine and be very careful about titrating up in order to avoid hyperthyroidism?

A

Elderly patients and patients with ischaemic heart disease

Endocrinology (6 decks)

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