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ENDOCRINOLOGY > Thyrotoxicosis > Flashcards

Thyrotoxicosis Flashcards

1
Q

Cardiac signs of thyrotoxicosis (2)

A

AF/SVT

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2
Q

Eye signs (not graves specific) (2)

A 
Lid lag
Lid retraction (lid above sclera
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3
Q

Graves’ signs (3)

A

Eye disease (2)
Pretibial myxoedema
Thyroid acropachy

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4
Q

Graves’ related eye dieases (2)

A

Exophthalmos

Opthalmoplegia

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5
Q

Pretibial myxoedema location and description

A

Oedematous swelling above lateral malleolus

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6
Q

Graves M>F? T or F

A

false - 9:1 F:M

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7
Q

Pathogenesis of graves

A

IgG autoantibodies
bind thyrotropin-R
Increase T3 and smooth thyroid enlargment
react with orbital antigens

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8
Q

Iodine-deficiency causes

A

Toxic multinodular goitre (surgery indicated for compressive symptoms - dysphagia)

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9
Q

Toxic adenoma

A

Solitary nodule producing t3/t4

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10
Q

Exogenous causes

A

Iodine intake excess, levothyroxine (^t4 not t3)

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11
Q

De Quervains thyroiditis is seen when with what goitre

A

Post-viral
Painful goitre
(it is self-limiting)

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12
Q

Drugs that cause thyroiditis (2)

A

Amiodarone

Lithium

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13
Q

How to control symptoms

A

PROPRANOLOL

B-adrenergic tone is up

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14
Q

What are the 2 approaches for anti thyroid medication

A

Titration

Block and replace

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15
Q

Explain block and replace

A

CARBIMAZOLE + THYROXINE silmultaneously

decrease risk of iatrogenic hypothyroidism

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16
Q

Explain titration treatment

A

CARBIMAZOLE for 4 weeks, reduce according to TFTs every 1-2 months

17
Q

Explain the treatment journey in Graves

A

Tx for c.18 months, 50% relapse. Then require surgery/radioiodine

18
Q

SE of carbimazole

A

agranulcytosis (0.03% –> dangerous sepsis. warn to stop and seek FBC/medical help if ulcer/infections)

19
Q

Risk of throidectomy

A

Recurrent laryngeal nerve damage (hoarse voice)

20
Q

CI for I131

A

Pregnant

Lactating

21
Q

Main risk factor for thyroid eye disease

A

smoking (stop!)

22
Q

Tx of severe ophthalmoplegia

A

IV METHYPREDNISOLONE

23
Q

All goitre is diffuse except (3)

A

Multinodular
Adenoma
Carcinoma

ENDOCRINOLOGY (19 decks)

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