Thyroid Issues Flashcards
What are the risk factors for Hypothyroid?
Obesity
PCOS
Depression
Fibroids
What are the symptoms of hypothyroid?
Brittle hair Tired all the time Heavy periods Constipation Low Mood Goitre
What investigations would you do in someone who is ‘tired all the time’?
FBC ESR/CRP WCC LFT U E IgA TTG TFT Fasting glucose HbA1c PHQ9 (depression)
What is the other name for hypothyroidism?
Myxoedema
What are the causes of hyperthyroidism?
Graves
Amiodarone
Thyroiditis
What symptoms does hyperthyroid present with?
Weight loss Tremor Palpitations Hyperactivity AF Eye changes Infertility Alopecia
What treatments are there for hyperthyroidism?
- BBs *(symptom control until drugs set in)
- Carbumazole
- Radioactive 131 I
- Surgery- partial or total thyroidectomy (reserve for those with large goitres)
What should you warn all patients on carbimazole?
Stop if any sore throat or infection
What is the mechanism of action of carbimazole?
Inhibits synthesis of thyroid hormones (given short term before surgery or long term but high relapse rate)
What is the issue with 131 I?
Takes 3-4 months to be effective.
Cannot be taken with Carbimazole
What are risk factors for a thyrotoxic storm?
Recent thyroid surgery or radioactive iodine
Infection
Trauma
MI
How does a hyperthyroid crisis present?
Fever Agitation Coma Tachycardia/ AF D + V Acute abdomen Goitre/ thyroid bruit
What do you do in a thyrotoxic storm?
Admit to hospital.
What is Grave’s disease?
The most common form of hyperthryoidism
Autoimmune antibodies to TSH receptors
What is Grave’s associated with?
Smoking
Stressful life events
What are the features of Graves?
Bruit
Hyperthyroidism
Thryoid eye disease
What is involved in thyroid eye disease?
Double vision Eye protrusion (exopthalmus and proptsosis) Lid lag Opthalmoplegia of upwards gaze TFTs can be normal or raised
What is the blood results of throtoxicosis?
Low TSH, high T4
What is the blood result of Hypothyroid?
Hi TSH, Low T4
What do you do with thyroid eye disease?
Refer to opthalmologist
URgent is losing colour vision or acuity as nerve involved
What are the causes of hypothyroid?
Chronic autoimmune thyroiditis
Post 131 I treatment
Post thyroidectomy
How do you treat hypothyroid?
Levothyroxine life long
