Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 2B > Thyroid History > Flashcards

Thyroid History Flashcards

1
Q

Describe what would happen in hyperthyroidism to change in body weight

A

Decrease despite increased appetite (although 10% will gain weight)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Describe what would happen hypothyroidism to change in body weight

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe what would happen in hyperthyroidism to change in appetite

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe what would happen in hypothyroidism to change in appetite

A

Decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe what would happen in hyperthyroidism to change in voice

A

No change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe what would happen in hypothyroidism to change in voice

A

Hoarseness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe what would happen in hyperthyroidism to change in energy level

A

Can increase or decrease
Muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe what would happen in hypothyroidism to change in energy level

A

Decrease
Somnolent
Slower movements and muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define somnolent

A

Tired and ready to fall asleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe what hyperthyroidism to change in mood

A

Anxious
Irritable
Emotionally liable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe what hypothyroidism to change in mood

A

Lethargy
Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What would happen in hyperthyroidism to change in concentration

A

Decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would happen in hypothyroidism to change in concentration

A

Decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What would happen in hyperthyroidism to change in heat tolerance

A

Sensitive to heat

Prefers a cool environment, wears fewer clothes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would happen in hypothyroidism to change in heat tolerance

A

Sensitive to cold

Prefers a warm environment, wears extra clothes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would happen in hyperthyroidism to change in skin, nails and hair

A

Increased sweating
Fine hair and hair loss
Clubbing (thyroid acropachy)
Onycholysis (separation of the nail from the nailbed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What would happen in hypothyroidism to change in skin, nails and hair

A

Dry flaky skin
Coarse thinning hair
Brittle nails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What would happen in hyperthyroidism to change in heart rate/rhythm

A

Tachycardia
Palpitations
Atrial fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What would happen in hypothyroidism to change in heart rate/rhythm

A

Bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What would happen to change in menstrual cycle in hyperthyroidism

A

Infrequent menses
Fertility problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What would happen in change in menstrual cycle in hypothyroidism

A

Heavy, prolonged or irregular menses
fertility problems and increased risk of miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define menses

A

Menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are 3 specific areas to cover in a thyroid history

A

Drug history and allergies
Social history
Family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is drug history important in thyroid history

A

Specifically enquire about thyroxine, lithium, amiodarone and glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is social history important in thyroid history

A

Smoking, alcohol, diet (sufficient iodine), and effect of activities of daily living

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Name 5 examples of glucocorticoids

A

Beclomethasone
Dexamethasone
Hydrocortisone
Prednisolone
Methylprednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why is family history important in a thyroid history

A

Thyroid disease can be familial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describe the role of T3 if it is high

A

Increases metabolism = weight decreases + potentiates effects of catecholamines e.g. adrenaline resulting in excessive sympathetic output (tremor, tachycardia, anxiety)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Describe the role of T3 if it is low

A

Results in weight gain, low mood, constipation, poor memory, hyporeflexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are you looking for when checking general appearance in a thyroid examination

A

Build
Inappropriate clothing
Restlessness
Confusion
Quality of skin and hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Describe thyroid acropachy

A

Similar appearance to finger clubbing - caused by periosteal phalangeal bone overgrowth secondary to Grave’s disease

31
Q

Describe onycholysis

A

Painless detachment of the nail from the nail bed associated with hyperthyroidism

31
Q

What is thyroid acropachy associated with

A

Secondary to graves disease

(similar appearance to finger clubbing but caused by periosteal phalangeal bone overgrowth)

32
Q

In thyroid condition when would onycholysis be seen

A

Hyperthyroidism

33
Q

In which thyroid condition would palmar erythema be seen

A

Hyperthyroidism

34
Q

Describe palmar erythema

A

Reddening of the palms associated with hyperthyroidism, chronic liver disease and pregnancy

35
Q

What hand signs are you looking for

A

Palmar erythema
Clubbing (thyroid acropachy)
Brittle nails
Onycholysis

36
Q

In peripheral tremor what is it a feature of

A

Hyperthyroidism

Reflecting the sympathetic nervous system overactivity

37
Q

How long much an irregular rhythm be calculated for

A

60 seconds

38
Q

What is a healthy adult pulse

A

60-100 bpm

39
Q

What is bradycardia and its causes

A

<60bpm

Healthy athletic individuals, hypothyroidism, atrioventricular block, medications, sick sinus syndrome

40
Q

What would be seen in a heart for hypothyroidism

A

< 60 bpm (bradycardia)

41
Q

Describe tachycardia and its causes

A

> 100bpm

Hyperthyroidism, anxiety, supraventricular tachycardia, hypovolaemia

42
Q

What thyroid condition is atrial fibrillation associated with

A

Atrial fibrillation

43
Q

What is dry skin associated with

A

Hypothyroidism

44
Q

What is excessive sweating associated with

A

Hyperthyroidism

45
Q

What is the absence of the outer 3rd of the eyebrows associated with

A

Hypothyroidism (rare sign)

46
Q

Describe exophthalmos

A

Proptosis (forward displacement of the eye)

Grave’s disease

47
Q

What bilateral eye feature is seen in Graves disease

A

Exophthalmos

48
Q

Why does exophthalmos occur

A

Bulging of the eye anteriorly out of the orbit

Due to oedema and lymphocytic infiltration of orbital fat, connective tissue and extraocular muscles

49
Q

Describe lid retraction

A

Inspect eyes from the front and note if sclera is visible between upper lid margin and the corneal limbus

50
Q

What thyroid condition is lid retraction seen in

A

All hyperthyroidism

Is most common ocular sign of Graves’ disease

51
Q

Describe why lid retraction occurs

A

Occur due to the sympathetic hyperactivity causing excessive contraction of the superior tarsal and levator palpebrae superioris muscles

52
Q

How do you inspect for lid lag

A

Ask patient to look down

Delayed downward movement of the eyelids on downgaze indicated lid lag sign

53
Q

What is lid lag a sign of

A

Hyperthyroidism

54
Q

What signs of inflammation are seen in thyroid disease

A

Due to lid retraction and exophthalmos, the eye is more prone to dryness and development of

conjunctival oedema (chemosis)

conjunctivitis

Corneal ulceration (severe cases)

55
Q

Define lid lag

A

Refers to a delay in the descent of the upper eyelid in relation to the eyelid when looking down

56
Q

If a lump in the neck moves when water is swallowed what does this suggest

A

Thyroid mass

57
Q

Describe the movement of thyroid gland masses (e.g. goitre) and thyroglossal cysts with swallowing

A

Typically move upwards

58
Q

Describe the movement of lymph nodes with swallowing

A

Typically move very little

59
Q

Describe the movement of n invasive thyroid malignancy with swallowing

A

May not move with swallowing if tethered to surrounding tissue

60
Q

Describe the movement of thyroglossal cysts when a patient protrude their toungue

A

Move upwards

61
Q

Why do you percuss in a thyroid examination

A

Percuss upper sternum for retrosternal extension of the goitre

62
Q

Why do you auscultate in a thyroid examination

A

For a bruit (each lobe) using bell of stethoscope

63
Q

What do bruits of the thyroid suggest

A

Indicates increased vascularity (typically occurs in Graves disease)

64
Q

What condition is thyroid bruits secondary to

A

Graves disease

65
Q

Describe proximal myopathy

A

(proximal weakness)

Potential complication of multinodular goitre and Graves’ disease

Develop wasting of their proximal musculature causing difficulties in tasks e.g. standing from a sitting position

66
Q

What conditions is proximal myopathy a potential complication of

A

Multinodular goitre and Graves disease

67
Q

What is hyporeflexia associated with

A

Hypothyroidism

68
Q

What is checking reflexes associated with

A

Hypothyroidism

69
Q

Describe pretibial myxoedema

A

Form of diffuse mucinosis in which there is an accumulation of excess glycosaminoglycans in dermis and subcutis of the skin

70
Q

How does pretibial myxoedema present

A

Waxy, discoloured induration of the skin on the anterior aspect of the lower legs (pre-tibial region)

71
Q

What is pretibial myxoedema a rare complication

A

Graves’ disease

72
Q

Give an example summary of a thyroid examination

A

“Today I examined Mr Smith, a 32-year-old male. On general inspection, the patient appeared hyperactive at rest, with a peripheral tremor. There were no objects or medical equipment around the bed of relevance.”

“The patient was tachycardic at 105 bpm with a regular pulse. Inspection of the neck was unremarkable but palpation revealed a mass in the thyroid region that contained multiple nodules. The mass moved upwards on swallowing but was stationary during tongue protrusion. There was no palpable lymphadenopathy but retrosternal dullness was present to the level of the manubrium. Auscultation of the thyroid gland did not reveal any bruits, reflexes were normal and there was no evidence of pretibial myxoedema or proximal myopathy.”

“In summary, these findings are consistent with a toxic multinodular goitre.”

“For completeness, I would like to perform the following further assessments and investigations.”

73
Q

What further investigations can be done after a thyroid examination

A

Thyroid function tests - TSH, T3, T4

ECG (if irregular pulse)

Ultrasound scan of neck

Phase 2B (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions