Thyroid Passmed Qs Flashcards

1
Q

De Quervain’s thyroiditis AKA

A

Subacute thyroiditis

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2
Q

DQ thyroiditis during thyroid scintigraphy

A

Globally reduced uptake of iodine

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3
Q

Sick euthyroid syndrome

A

Caused by systemic illness
Low total + free T4/3 (levels only mildly below normal)
Normal TSH

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4
Q

Increased TSH

Normal T4

A

Subclinical hypothyroidism

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5
Q

Papillary thyroid cancer

A
65%
Young females
Metastasis to cervical lymph nodes
Thyroglobulin used as tumour marker
Orphan Annie eyes on light microscopy
Good prognosis
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6
Q

Follicular thyroid cancer

A
20%
Generally women > 50
Metastasis to lung and bones
Thyroglobulin can be used as tumour marker
Moderate prognosis
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7
Q

Medullary thyroid cancer

A

5%
Sporadic or part of MEN2 syndrome
Originates from parafollicular cells which produce calcitonin
Calcitonin can be used as tumour marker

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8
Q

Anaplastic thyroid cancer

A

V rare
Elderly
Poor prognosis

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9
Q

Lymphoma

A

5%

Dysphagia or stridor

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10
Q

MEN 1

A

Pituitary adenoma
Parathyroid hyperplasia (leading to hyperparathyroidism)
Pancreatic tumours- insulinoma, gastrinoma

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11
Q

MEN 2A

A

Parathyroid hyperplasia
Medullary thyroid carcinoma
Phaeochromocytoma

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12
Q

MEN 2B

A

Mucosal neuroma
Marfanoid appearance
Medullary thyroid carcinoma
Phaeochromocytoma

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13
Q

Hashimoto’s thyroiditis clinical features

A

Hypothyroidism
Goitre
Anti-TPO

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14
Q

Toxic multi nodular goitre treatment

A

Radioactive iodine treatment of choice

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15
Q

DQ thyroiditis presentation

A
Thought to occur after viral infection
Typically presents with hyperthyroidism
Painful goitre
Raised ESR
Reduced iodine 131 uptake on scan
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16
Q

Thyrotoxicosis with tender goitre

A

Subacute (DQ) thyroiditis

17
Q

Secondary hypothyroidism

A

Low TSH
Low T4
–> do MRI of gland

18
Q

Grave’s + eye symptoms

A

Doesn’t need to have eye symptoms to be graves

19
Q

Low thyroxine compliance

A

If don’t take thyroxine, High TSH and low T4- often patients over compensate before appointment, leading to an increase in T4 without enough time for TSH to be compressed (days/weeks)
–> High TSH and High T4

20
Q

Subclinical hypothyroidism in elderly

A

Watch and wait

21
Q

Carbimazole + agranulocytosis

A

ESR test needs to be done

Warn of sore throat

22
Q

Toxic adenoma

A

Low TSH

Hot solitary nodule

23
Q

Hyperthyroidism + period

A

Associated with oligomenorrhea

24
Q

Subacute thyroiditis

A

Causes hyper then hypothyroidism

25
Thyrotoxic storm treatment
Beta blockers Propylthiouracil Hydrocortisone
26
Myxoedemic coma
Hypothermia Hyporeflexia Bradycardia Seizures
27
Myxoedemic coma treatment
Thyroxine | Hydrocortisone
28
Iron + thyroxine
Iron reduces its absorption
29
Graves autoantibodies
TSH receptor stimulating antibodies (90%) | Anti-thyroid peroxidase antibodies (75%)
30
Changes in vision with thyroid eye disease
Urgent review by specialist
31
Subclinical hypothyroidism
Normal T3 High TSH If TSH between 4-10: Below 65 give levothyroxine, above 65 watch and wait, if asymptomatic observe + repeat TFTs 6 months If TSH above 10- Below 70 start thyroxine
32
Subclinical hyperthyroidism
Normal T3 Low TSH Causes- multinodular goitre, excessive thyroxine Effects CVS (AF), Osteoporosis Increased risk dementia Give low dose anti-thyroid drugs for 6 months
33
Hypothyroidism electrolyte
Decreased Na
34
Hyperthyroidism electrolyte
Increased Ca
35
Hypothyroidism + periods
Menorrhagia | MORE PERIOD