Topic A4 Flashcards

1
Q

What is the thyroid responsible for in the body?

A

Produces hormones to regulate body’s metabolic rate
As well as;
- Heart & digestive function
- Muscle control
- Brain development
- Bone maintenance

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2
Q

What happens in the body for someone with hypothyroidism?
(Underactive thyroid)

A

1) Dry & coarse hair
2) Thinning of eyebrows
3) Puffiness in face
4) Slow heart rate
5) Weight gain
6) Constipation
7) Brittle nails
8) Low body temperature
9) Cold intolerance
10) Depression
11) Fatigue
12) Muscle aches

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3
Q

What happens in the body for someone with hyperthyroidism?
(Overactive thyroid)

A

1) Hair loss
2) Bulging eyes
3) Thin & hollow face
4) Rapid heart rate
5) Weight loss
6) Diarrhea
7) Soft nails
8) High body temperature
9) Sweating
10) Heat intolerance
11) Irritability
12) Wired & tired
13) Muscle weakness

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4
Q

What is Graves’ Disease? & what are the risk factors?

A

It is an autoimmune disorder where the immune system mistakenly attacks the thyroid
- ^This causes hyperthyroidism
- 3 in 4 w hyperthyroidism get this disease
- Cause of disease is unknown

Risk Factors:
- young to middle-aged women mostly affected
- usually runs in families
- smoking is also a risk

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5
Q

What is thyroid eye disease?

A

Aka Graves’ ophthalmopathy/ orbitopathy

It is a common orbital disorder
Also the most common cause for proptosis in adults (bilateral/unilateral)

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6
Q

What are the clinical features for thyroid eye disease?

A

1) Soft Tissue involvement
2) Lid Retraction
3) Proptosis
4) Restrictive Myopathy
5) Optic Neuropathy

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7
Q

What are the things that px experience due to soft tissue involvement?

A

1) Grittiness/FB sensation
2) Red Eyes = sign for inflammatory activity
3) Lacrimation - insufficient & instable tears
4) Photophobia
5) Corneal involvement exacerbated by lid retraction

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8
Q

What are the things that px experience due to lid retraction?

A

1) Retraction = upper & lower lid
2) ^ exposing superior & inferior sclera
3) Overaction of muller muscle
4) Fibrotic contracture of levator palpebrae & inferior rectus
5) “Staring” appearance

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9
Q

What are the things that px experience due to proptosis?

A

1) Bulging eye forward
2) Unilateral/Bilateral
3) Severe proptosis = compromise lid closure
- causes keratopathy & other corneal complications

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10
Q

What are the things that px experience due to restrictive myopathy?

A

1) OM restricted due to inflammatory fibrosis
2) Occurs in 30%-50% of px
3) Most commonly causes an elevation defect

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11
Q

What are the things that px experience due to optic neuropathy?

A

1) Due to compression of optic nerve/blood supply
2) Occurs in 6% of px
3) MAY lead to central vision impairment (reduced VA)
4) Colour desaturation
5) VF defect either central/paracentral

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12
Q

What are the signs & symptoms of thyroid eye disease?

A

1) Photophobia
2) Ophthalmoplegia = paralysis of muscles within/surrounding the eye
3) Lid lag = upper eyelid higher than normal w globe in down gaze
4) FB sensation
5) Tearing
6) Lid retraction & stare
7) Proptosis
8) Corneal exposure = inferior corneal staining
9) Increased IOP

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13
Q

What are the management guidelines for thyroid eye disease?

A

1) Lid retraction = lid taping during sleep/surgery
2) Ocular surface involvement = Lubricants, topical anti-inflammatory agents
3) Proptosis = Systemic steroids (also monitor px for steroid induced glaucoma)
4) Restrictive Myopathy = use prisms @ initial stage & surgery in later stage
5) Optic Neuropathy = Systemic steroids (same as proptosis - monitor px)

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