Thyroid Jazz Flashcards
What are serum levels in hyperthyroidism?
high T4 and low TSH
What are symptoms of hyperthyroidism?
- Tremor
- Anxiety
- Palpitations
- Heat intolerance
- Diarrhoea
- Olgiomenorrhea
What is causes of hyperthyroidism
- Grave’s disease
- Toxic multinodular goitre
- Thyroiditis
- Drugs (e.g. amiodarone)
What is Grave’s disease associated with?
anti-TSH receptor antibodies
What is the management of hyperthyroidism?
- Propranolol: T4 and T3 leads to increased expression of B-adrenergic receptors
- Carbomazole (TPO inhibitor)
- Radioiodine
What are serum TSH and T4 levels in hypothyroidism?
Low T4 and high TSH
What are symptoms of hypothryoidism?
- Lethargy
- Cold intolerance
- Weight gain
- Constipation
- Meorrhagia
- Decreased deep tendon reflexes
What are causes of hypothyroidism?
- Hashimoto’s thyroiditis
- Subacute (de Quervain’s) thyroiditis
- Drugs: (e.g. amiodarone, lithium)
- Iodine deficiency
What is hashimotos associated with?
anti-TPO antibodies
What is management of hypothyroidism?
levothyroxine
What are the features of thyroid cancer?
- Non functional, painless, rapidly gorwing
- Solitary irregular (nodular) shape
- Palpable nodule: hard and fixed
- HOARSE VOICE
- Dysphagia
- Haemoptysis
- Airway obstruction
- Cervical lymphadenopathy
What are different types of thyroid cancer and how common are they?
- Papillary carcinoma (70%)
- Follicular carcinoma (20%)
- Medullary carcinoma (5%)
- Anaplastic carcinoma (1%)
- Lymphoma (rare)
How does papillary carcinoma present?
35 y/o female with childhood radiation exposure
How does follicular carcinoma present?
50 y/o female with low dietary iodine intake
What is a rare variant of follicular carcinoma?
hurthle cell
What is medullary carcinoma associated with?
MEN 2A and MEN 2B
What investigations are used in thyroid cancer>
- FNAB w/USS
- CT/PET
- thyroid scan
- TFTs can be useful to exclude benign (functional) nodules
How does papillary carcinoma grow?
grow with characteristic neoplastic papillae + psammoma bodies + ground-glass nuclei
What is a psammoma body?
circular, calcified concentric laminations/rings
What is a follicular carcinoma?
invasion of BENIGN follicular adenoma into thyroid capsule or blood
Where are follicular and papillary carcinomas dervied from?
follicular cell
What is medullary carcinoma associated with?
cancer of C-cells, produces calcitonin (measured in blood)
What is management of thyroid cancer?
- Total thyroidectomy
- Radioiodine (to kill remaining thyroid tissue)
Routine thyroglobulin monitoring and thyroid hormone replacement (levothyroxine)
In graves disease what other signs may there be?
- bilateral exopathlamos
- lid lag (and retraction)
- pretibial myoxema
- thyroid acropachy
