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FINALS - ENDOCRINE > thyroid - overactive > Flashcards

thyroid - overactive Flashcards

1
Q

bloods for subclinical hyperthyroid

A

normal free T3/4 // TSH < 0.1

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2
Q

causes of subclinical hyperthyroid

A

multinodular goitre - esp elderly females

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3
Q

complications subclinical hyperthyroid

A

AF, osteoporosis, dementia

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4
Q

mx subclinical hyperthyroid

A

observe // trial low-dose Anti-thyroid for 6 months

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5
Q

bloods in primary hyperthyroid

A

low TSH // high free T4

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6
Q

bloods in secondary hyperthyroid

A

high TSH // high free T4

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7
Q

general + GI + neuro symptoms hyperthyroid (7)

A

weight loss // restlessness // too hot // anxiety // tremor // diarrhoea

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8
Q

cardio, skin, gynae, symptoms hyperthyroid

A

palpitations, tachycardia // high CO failure // sweating // pretibial myoxedema // clubbing // oligomenorrhoa

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9
Q

what is pretibial myxoedema

A

red, oedema on lateral malleolus

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10
Q

eye symptoms hyperthyroid

A

expothalamus (bulging) // conjunctival oedema // papilloedema // opthamloplegia // can’t close eyes

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11
Q

RF developing thyroid eye disease

A

smoking // radioiodine

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12
Q

what is deposited in the eye muscles in graves

A

glycosaminoglycan + collagen

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13
Q

mx thyroid eye disease

A

lubricants // steroids // radio // surgery

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14
Q

who should mx thyroid eye disease

A

deterioration of vision –> urgent optho

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15
Q

causes thyrotoxicosis

A

graves // toxic nodular goitre // acute de Quervains or post-partum // amiodarone // contrast

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16
Q

invx hyperthyroid

A

TSH // antibodies // iodine isotope scan

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17
Q

most common cause hyperthyroid

A

graves

18
Q

who usually gets graves

A

women 30-50

19
Q

symptoms Graves

A

expothalamus, opththalmoplegia // pretibial myxoedema // thyroid acropachy - clubbing, soft tissue swelling, periosteal bone

20
Q

antibodies in graves

A

TSH (90%) TPO (75%)

21
Q

what is seen on thyroid scintigraphy of graves

A

diffuse, homogenous, increase uptake of radioactive iodine

22
Q

initial mx graves

A

propanolol to control symptoms

23
Q

who manages graves patients and what mx can be started in primary care

A

refer to endocrinologist (carbimazole can be given by GP if not controlled with propanolol)

24
Q

1st line ATD for hyperthyroid

A

carbimazole 40mg and reduce gradually for 12-18 months

25
Q

what drug is added in hyperthyroid when euthyroidism is met

A

thyroxine

26
Q

SE carbimazole

A

agranulocytosis // crosses placenta

27
Q

2nd line ATD hyperthyroid

A

Propylthiouracil

28
Q

when is radioiodine used in graves

A

relapse following ATD/ resistant

29
Q

contraindications radioiodine

A

pregnancy // <16 // (thyroid eye dease relative)

30
Q

SE radioiodine

A

hypothyroid

31
Q

what is toxic multinodular goitre cause

A

multiple thyroid nodules –> hyperthyroid

32
Q

nuclear scintigraphy toxic multinodular goitre

A

patchy uptake

33
Q

mx toxic multinodular goitre

A

radioiodine therapy

34
Q

what can cause thyroid storm

A

thyroid surgery // trauma // infection // iodine load eg CT contrast

35
Q

symptoms thyroid storm

A

fever >38.5 // raised HR // confusion + agitation // N+V // raised BP // HF // jaundice + LFTs

36
Q

mx thyroid storm (4)

A

IV propranolol // ATD eg methimazole or propylthiouracil // Lugols iodine // dexamethasone

37
Q

what causes subacute De Quervains thyroiditis

A

viral infection

38
Q

phases DeQuarvains thyroiditis

A

1 = 3-6 weeks of hyperthyroid, painful goitre // 2 = euthyroid // 3 = weeks - months hypothyroid

39
Q

what blood is raised in phase 1 subacute thyroiditis

A

ESR

40
Q

invx subacute thyroiditis

A

thyroid scintigraphy - reduced uptake of iodine 131

41
Q

mx subacute thyroiditis

A

self limitn // aspirin, NSAIDs, steroids

FINALS - ENDOCRINE (14 decks)

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