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Endocrine > Thyroid Pathology > Flashcards

Thyroid Pathology Flashcards

1
Q

thyroid pathology is either 1y or 2y- what does this mean?

A 
1y= disease affecting the thyroid gland
2y= hypothalamic/ pituitary disease so no gland pathology
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2
Q

difference between hyperthyroidism and thyrotoxicosis

A

hyperthyroidism= when there is overproduction of thyroid hormone

thyrotoxicosis= abnormal quantities of thyroid hormone in body

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3
Q

aetiology of hyperthyroidism

A

excess thyroid stimulation: Grvae’s, hashitoxicosis, tumours, choriocarcinoma

thyroid nodules with autonomous function: toxic nodular goitre, adenoma

rare aetiology: thyroiditis, ectopic thyroid tissue, exogenous (levothryoxine)

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4
Q

s/s of hyperthyroidism

A

metabolism if OVERactive
- palpitation, anxiety, wt loss/ inc appetite, eye disease (proptosis, lid retraction), thin hair, heat intolerance, sexual dysfunction

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5
Q

ix findings for hyperthyroidism

A

1y: free T3/T4 inc, low TSH (compensation)
2y: inc T3/T4, normal/high TSH

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6
Q

subclinical finding for hyperthyroidism

A

dec TSH (<0.1)

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7
Q

mx for hyperthyroidism

A

antithyroid drugs- carbimazole, PTU (PTU is 1st line in 1st trimester of pregnancy)

BBs, radioiodine therapy (RAI)

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8
Q

main risk with antithyroid drugs?

A

agranulocytosis- bone marrow suppression causing leukopenia

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9
Q

main risk posed with surgery for thyroid disease

A

recurrent laryngeal nerve paralysis

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10
Q

thyroid storm is…

A

emergency of severe hyperthyroidism- resp/cardiac distress, hyperthermia, exaggerated reflex.
mx- ABCs, iodine, PTU, BBs

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11
Q

aetiology of hypothyroidism

A

1y: goitrous (hashimoto’s, drugs (Lithium/ amiodarone)), non-goitrous (atrophic thyroiditis- poster chemo, congenital etc)
2y: hypothalamus/ pituitary disease, where not enough TSH produced

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12
Q

s/s of hypothyroidism

A

metabolism is UNDERactive
- coarse hair, dull face, pale/dry skin, fluid retention, cold intolerance, constipation, wt gain/reduced appetite, menorrhagia

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13
Q

ix findings for hypothyroidism

A

1y: free T3/T4 low, TSH high
2y: free T3/T4 low, TSH normal/low

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14
Q

subclinical clinical findings for hypothyroidism

A

low TSH

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15
Q

mx for hypothyroidism

A

levothyroxine (synthetic T4), in elderly give lower 25mg dose

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16
Q

complications of hypothyroidism

A

myxoedema: severe hypothyroidism
- T2 resp failure, adrenal failure. ECG has signs of arrhythmias
- mx: ABCs, thyroxine, cardiac monitoring

17
Q

aetiology of thyroiditis

A

viral, hashimotos

18
Q

types of thyroditiis

A

De Quervain’s Thyroiditis, postpartum thyroiditis, drug induced (amiodarone), acute suppurative thyroiditis

19
Q

s/s of thyroiditis & mx

A

neck tenderness, fever, viral

mx- BBs, NSAIDs

20
Q

scintigraphy scan is used for..

A

thyroiditis- shows low T4 uptake

21
Q

euthyroid sick syndrome is…

A

abnormal thyroid function results with no thyroidal illness/ or hypo-pit dysfunction

22
Q

what is the usually thyroid function test reading for euthyroid

A

low TSH, low T3/T4

23
Q

what is Grave’s Disease

A

AI condition where there are antibodies against TSHr causing hyperthyroidism

24
Q

T/F: thyroid is 10:1 in females

A

T !!!

25
Q

what is the classic triad of Grave’s

A

goitre + hyperthyroidism, exophthalmos, pretibial myxoedema

26
Q

Grave’s/ hyperthyroidism often has…

A

eye disease

- exophthalmos, lid lag

27
Q

T/F: Grave’s eye disease often associated with alcohol

A

F: smoking

28
Q

ix for Grave’s

A

low TSH, high T3/T4

ABs: TSHr AB*, anti-thyroid peroxidase,

29
Q

what is hashimotos

A

leads to gradual failure of thyroid function due to AI destruction of tissue

30
Q

pathophysiology of Hashi

A

anti-thyroid ABs > activated CD8+ cells > cytokine mediated cell death

31
Q

T/F: hashimotos may have a period of transient hyper function of the thyroid

A

T- known as hashimotos thyrotoxicosis

32
Q

which ABs would be seen on ix

A

anti-thyroid peroxidase, antithyroglobulin antibodies

33
Q

T/F: hashimotos thyroiditis is initially small then grows

A

F: initially diffusely large > becomes atrophic

34
Q

a goitre is a…

A

midline thyroid mass

35
Q

what are the 2 main types of goitre

A

diffuse: usually iodine deficiency, T3/T4 normal, TSH high

multi-nodular: evolution from longstanding solitary goitre. may be toxic multi nodular goitre

36
Q

what is toxic multi nodular goitre?

A

autonomous nodules producing continuous excessive thyroid hormone causing hyperthyroidism

37
Q

radioidoine is 1st line for…

A

relapsed Grave’s or toxic multi nodular goitre

Endocrine (14 decks)

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