Thyroid Investigations Flashcards

1
Q

What are the optimal ratios of;
FT3/FT4 =
T3/RT3 =

A
FT3/FT4 = >0.33
T3/RT3 = >6
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2
Q

What do comphressive thyroid tests NOT assess?

A

Tissue levels of T3

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3
Q

What is the opitmal range of TSH?

A

0.4-2.5

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4
Q

What is the optimal range of Total T4?

A

70-150

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5
Q

What is the opitmal range of FT4?

A

12.8-19.5pg/ml

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6
Q

What is the optimal range of FT3?

A

3.2-4.5pg/ml

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7
Q

What is the opitmal range of Thyroglobulin antibodies?

A

no optimal range

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8
Q

What is the optimal range of TPO antiobodies?

A

No optimal range

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9
Q

What is the optimal range of RT3?

A

11-18ng/dl

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10
Q

High TSH + Normal T4 and T3 =

A

subclinical hypothyroidism

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11
Q

High TSH + Low T4 + low/normal T3 =

A

Hypothyroidism

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12
Q

Low TSH + normal T4 and T3 =

A

Subclinical hyperthyroidism (unless on T4 therapy)

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13
Q

Low TSH + high/normal T4 and T3 =

A

Hyperthyroidism

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14
Q

Low TSH + low T4 and T3 =

A

Secondary hypothyroidism

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15
Q

What needs to be checked on a thyroid test for a full assessment?

A

Total and free T4, total and free T3, RT3 and thyroid antibodies

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16
Q

What is the most accurate way of measuring iodine status?

A

urine iodine test

17
Q

What is the range of the ‘iodine goal’ in a urine test taken on the first urination of the day in children and adults?

A

100-199mcg/L

18
Q

What is the range of the ‘iodine goal’ taken in a urine iodine test for pregnant women?

A

150-249mcg/L

19
Q

On a urine iodine test, what level indicates iodine insufficiency in children and adults (unless pregnant)?

A

<100mcg/L

<20 = severely deficient

20
Q

What test is a useful indicator for testing for low thyorid?

A

Barnes Basal Body Temperature Test

21
Q

How does the Barnes Basal Body Temperature Test work?

A

auxillary temperature is taken on waking each monring for 7 days and an average is calculated. <36.5 indicated low thyroid

22
Q

What can effect the Barnes Basal Body Temerptaure Test results?

A
Circadiuan changes
Illness
Menstrual changes
Sedentary lifestyle
Light exposure
Alcohol intake
23
Q

Name indicators of thyroid issues through physical examination

A
Presence of goitre
dry skin
nail beading
thinning eyebrows
hair loss
low BP
bradycardia (<60BPM)
24
Q

Why is it useful to investigate SNPs when doing a thyroid report?

A
May cause;
Thyroid imbalance
AI
Inflammation
HPT axis
Impact cofactors
25
Q

Other than conventional testing a full thyroid panel, what other tests can be used for thyroid investigations?

A

Barnes Basal Body Temperature Test
Urine Iodine Test
Physical Examination
SNPs testing