Thyroid pathology Flashcards

1
Q

What is myxoedema?

A

Severe hypothyroidism

Medical emergency

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2
Q

What is Grave’s disease?

A

A rare autoimmune condition that can cause hyperthyroidism

IgG antibodies bind to TSH, stimulating thyroid hormone production

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3
Q

What are 3 autoimmune causes of hypothyroidism?

A

Atrophic thyroiditis
Hashimoto’s thyroiditis
Postpartum thyroiditis

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4
Q

What is atrophic thyroiditis?

A

Autothyroid antibodies are present which eventually result in atrophy and fibrosis of gland

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5
Q

What is Hashimoto’s thyroiditis?

A

autoimmune destruction of thyroid gland which lowers hormone levels

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6
Q

What is postpartum thyroiditis?

A

After pregnancy the immune system is altered which can result in hypo/hyper -thyroidism

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7
Q

What indicates permanent hypothyroidism in postpartum thyroiditis?

A

When conventional autoantibodies are found

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8
Q

List a cause of hypothyroidism that is to do with hormone deficiency?

A

Iodine deficiency

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9
Q

List some symptoms and signs of hypothyroidism…

A
weight gain
cold intolerance
bradycardia
dry hair/skin
tiredness
anaemia
constipation
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10
Q

What is the 1st line investigation in suspected hypothyroidism and what are the results?

A

Serum TSH

high TSH, low T4/T3

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11
Q

How do you manage hypothyroidism?

A

Levothyroxine (T4)
young - 50-100 micrograms
old - 25-50 micrograms

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12
Q

What is the most common cause of hypothyroidism?

A

Hashimoto’s thyroiditis

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13
Q

What is the typical patient that has myxoedema coma?

A

elderly woman with untreated hypothyroidism

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14
Q

What is the most common cause of hyperthyroidism?

A

Grave’s disease

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15
Q

List some symptoms and signs of hyperthyroidism…

A
Weight loss
irritability
heat intolerance
sweating
thirst
diarrhoea
eye disease (only in Grave's)
tachycardia/AF
goitre
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16
Q

List one feature of Grave’s disease…

A

thyroid eye disease

17
Q

What is thyrotoxicosis?

A

The state of tissues due to excess thyroid hormone

18
Q

List causes of thyroiditis…

A
Grave's
solitary nodule
toxic multinodular goitre
De quervain's thyroiditis
psotpartum thyroiditis
19
Q

What investigation is done in suspected hyperthyroidism and what will it show?

A

serum TSH

low TSH, high T4 or T3

20
Q

What are 4 ways to manage hyperthyroidism?

A

Antithyroid drugs
Beta blockers
radioiodine
thyroidectomy

21
Q

What is the first line antithyroid drug?

A

carbimazole

22
Q

What antithyroid drug is used in the first trimester of pregnancy?

A

Propylthiouracil

23
Q

When is radioidine the 1st line treatment for hyperthyroidism?

A

relapsed Grave’s disease or nodular thyroid disease

24
Q

What is a thyroid storm and who is it likely to affect?

A

Severe hyperthyroidism
Emergency

Thyroid pts. with recent thyroid surgery or acute illness

25
Q

What is sick euthyroid syndrome?

A

In an unwell patient

suppressed TSH but then rises during recovery

26
Q

What is goitre?

A

thyroid enlargement

27
Q

list 3 causes of diffuse goitre…

A
Simple goitre (no clear cause)
autoimmune thyroid disease 
thyroiditis
28
Q

What percentage of thyroid nodules are malignant?

A

5%

29
Q

Does a thyroid nodule move on swallowing?

A

yes

30
Q

What is the most common malignant thyroid nodule?

A

papillary thyroid carcinoma

31
Q

What are the different types of malignant thyroid nodule?

A
papillary thyroid carcinoma
follicular thyroid carcinoma
medullary thyroid carcinoma
lymphoma
anaplastic
32
Q

What investigations can be done if there are present thyroid nodules?

A

TSH

Fine needle aspiration guided by ultrasound