Thyroid Dysfunction

Question 1

what is a goitre

Answer 1

enlargement of the thyroid gland when it is over stimulated

Question 2

what is hypothyroidism

Answer 2

when the thyroid gland is not producing enough of the thyroid hormones

Question 3

what are symptoms of hypothyroidism

Answer 3

obesity, bradycardia, hoarse voice, slow reflexes, tiredness, cold intolerance, menorrhagia, puffy face/hands/feet, loss of outer 1/3 eyebrow, non pitting oedema

Question 4

what happens to the TSH levels in hypothyroidism

Answer 4

they increase

Question 5

what causes hypothyroidism

Answer 5

TSH/TRH deficiency 
inadequate iodine 
autoimmunity 
congenital 
surgical removal of thyroid gland

Question 6

what condition is seen in children with hypothyroidism and what are the features of this

Answer 6

cretinism - dwarfed statue, mental deficiency, poor bone development, slow pulse, muscle weakness

Question 7

what condition is seen in adults with hypothyroidism and what are the features of this

Answer 7

myxedema - thick puffy skin, muscle weakness, slow speech, mental deterioration, intolerance to cold

Question 8

what is the autoimmune disease causing hypothyroidism and what are the treatments

Answer 8

Hashimoto’s disease

treatment = oral thyroid hormone

Question 9

what is the autoimmune disease causing hyperthyroidism

Answer 9

Graves’ disease

Question 10

what causes hyperthyroidism

Answer 10

• autoimmune
• toxic multinodular goitre
• drugs
• thyroid carcinoma

Question 11

what are the symptoms of hyperthyroidism

Answer 11

weight loss, heat intolerance, tachycardia, weakness, increased appetite, hyper reflexive, amenorrhea, tiredness, warm sweaty hands, bounding pulse, lid lag, staring eyes

Question 12

how does Graves’ disease work

Answer 12

causes the production of thyroid stimulating immunoglobulin which stimulates thyroid hormone secretion

Question 13

what happens to the TSH levels in hyperthyroidism

Answer 13

decrease

Question 14

what radioisotope is used to scan the thyroid gland

Answer 14

technetium 99

Question 15

what drug is used to treat overactive thyroid

Answer 15

carbimazole

Question 16

what does carbimazole do

Answer 16

its a pro drug which is converted into methimazole in the body which prevents thyroid peroxidase from coupling the iodinating tyrosines on the thyroglobulin

Question 17

what is lingual thyroid

Answer 17

where part of the thyroid gland stays on the tongue as it didn’t migrate down during development

Question 18

why does a thyroglossal duct cyst form

Answer 18

when not all of the thyroglossal duct disappears during development

Question 19

where are thyroglossal duct cysts found

Answer 19

on the anterior part of the neck in the midline

Question 20

what causes the thyroglossal cyst to move upwards

Answer 20

tongue protrusion

Question 21

what is an adenoma

Answer 21

benign tumour of the glandular epithelia tissue

Question 22

what causes the majority of thyroid diseases

Answer 22

primary abnormality of the thyroid gland itself

Question 23

why is there such a wide range for normal thyroid hormone levels

Answer 23

the hypothalamus is constantly responding to the changes in the environment

Question 24

what 3 classifications of goitres are there

Answer 24

• diffuse (affecting the whole thyroid)
• multinodular
• single nodule

Question 25

in which gender are goitres more prevalent in

Answer 25

females

Question 26

what is a physiological goitre

Answer 26

swelling of the thyroid gland however there is still normal thyroid function

Question 27

what is the most common cause globally of goitre

Answer 27

iodine deficiency - the reduced thyroxine levels leads to increased TSH leading to thyroid enlargement (usually nodular)

Question 28

in which areas is iodine deficiency seen

Answer 28

mountainous areas (as theres iodine in the sea)

Question 29

what is the most common cause of goitre in the uk

Answer 29

Multinodular goitre where the cause is unknown. It may cause hyperthyroidism making it a toxic multinodular goitre

Question 30

what happens to the child if the mother is iodine deficient in pregnancy

Answer 30

the child may develop mental retardation, abnormal gait, short statue, goitre and hypothyrodism

Question 31

what is a retrosternal multinodular goitre

Answer 31

where a multinodular goitre enlarges inferiorly compressing the trachea

Question 32

what is thyrotoxicosis

Answer 32

excessive amount of thyroid hormones

Question 33

what is lid lag

Answer 33

delay of moving the eyelid down as the eye moves down

Question 34

what is staring eye

Answer 34

when the levator palpebrae superioris muscle is constantly stimulated due to the increased sympathetic stimulation

Question 35

what causes hyperthyroidism

Answer 35

• autoimmune
• toxic multinodular goitre
• toxic adenoma

Question 36

what is seen in graves disease

Answer 36

Exopthalmos (bulging of the eyes)

Pre-tibial myxoedema

Question 37

what is myxoedema

Answer 37

non pitting oedema due to depositions of mucopolysaccharides

Question 38

how does a toxic adenoma cause hyperthyroidism

Answer 38

the adenoma can independently produce thyroxine

Question 39

what are the treatments for hyperthyroidism

Answer 39

• carbimazole
• thyroidectomy
• radioactive iodine

Question 40

true or false: thyroid cancers cause hypothyroidism

Answer 40

false - they do not cause either hypo or hyper

Question 41

what 3 causes of goitres have no metabolic affects

Answer 41

• thyroid cancer
• iodine deficiency
• multinodular goitre

Question 42

what 4 causes of a goitre also cause metabolic dysfunction

Answer 42

• graves
• hashimotos
• toxic adenoma
• toxic multinodular goitre