Thyroid Dysfunction Flashcards
What attaches the thyroid gland to the trachea and larynx?
pre-tracheal fascia
Thus the thyroid moves upwards on swallowing
What is usually used for a thyroid uptake scan
Technetium 99
What is a thyroglossal duct cyst?
Embryological anatomical structure forming an open connection between the initial area of development of the thyroid gland and its final position. Forms swelling in anterior part of neck, always in the midline.
TSH and free thyroxine (T4) in hypothyroidism and hyperthyroidism
Hypothyroidism
- TSH increased
- T4 decreased
Hyperthyroidism
- TSH decreased
- T4 increased
Who are autoimmune endocrine diseases more common in and why?
Women, we don’t know
Types of goitre
Diffuse
Multinodular
Single nodule
When can physiological goitre occur?
Menarche, pregnancy, menopause
Commonest causes of goitre globally
Iodine deficiency - reduced thyroxine levels, increased TSH, severe cases may become hypothyroid
Multinodular goitre - aetiology unknown, normal thyroid function, may develop into toxic multinodular goitre
Effects on child from iodine deficient pregnancy
- Mental retardation
- Abnormal gait
- Deaf mutism
- Short stature
- Goitre
- Hypothyroidism
Symptoms of hypothyroidism
- Excessive tiredness
- Memory problems, depression, psychosis (myxoedema madness)
- Weight gain
- Cold intolerance
- Gruff voice, croaky voice
- Puffy eyes , face hands and feet
- Dry, flaky skin
- Hair loss, particularly outer third of eyebrows
- Symptoms of carpal tunnel syndrome
- Constipation
- Menorrhagia (heavy bleeding)
- Muscle weakness and cramps
- Pallor
- Bradycardia
- Hyporeflexia and delayed relaxation
- Non pitting oedema
- Ascites
Hashimoto’s disease
- Ten times commoner in women
- Antibodies to thyroglobulin and thyroid peroxidase
- Thyroid gland may initially enlarge and then shrink in size, or may not enlarge at all
Treatment for hypothyroidism
Oral thyroxine, not destroyed by gastric acid
Symptoms of thyrotoxicosis
- Overactivity, tiredness
- Nervousness, anxiety, insomnia
- Shaking, trembling
- Heat intolerance
- Increased sweating – warm sweaty hands
- Palpitations. Rarely angina
- Weight loss in spite of increased appetite
- Diarrhoea
- Amenorrhea
- Proximal muscle weakness
- Tachycardia, atrial fibrillation
- Proximal myopathy
- Lid lag
- Staring eyes
Causes of thyrotoxicosis
- Graves disease
- Toxic multinodular goitre
- Toxic adenoma
Graves’ Disease
- Exopthalmus and pre-tibial myxoedema are signs
- Caused by thyroid stimulating immunoglobulin (TSI), which attaches and stimulates TSH receptor
