Treatment of thyroid disorders Flashcards
what is the effect of thyroid hormones on the cardiovascular system
increase ionotropic, chronotropic, cardiac output
what is transient neonatal thyrotoxicosis
mother with grave’s disease causes neonate with hyperthyroidism
what are the causes of hyperthyroidism
graves disease
overtreatment with thyroxine
thyroid adenoma
transient neonatal thyrotoxicosis
what investigations should be done
measure blood for TSH, T3 and 4 levels
test for antithyroid antibodies
radionucleotide thyroid scan
what are the treatments for hyperthyroidism
radioactive iodine, anti thyroid drugs, surgery (none is optimal and none interrupts the autoimmune process)
how is radioiodine used
given orally and selectively taken up by the thyroid. single dose
damages cells and eventually causes hypothyroidism which can be treated with replacement therapy
name hyperthyroidism drugs which decrease synthesis of thyroid hormone
thioureylenes, carbimazole, propylthiouracil
inhibit thyroperoxidase which reduces the iodination of thyroglobulin
acts over 3-4 weeks
how is iodine used to treat hyperthyroidism
given orally in high doses
converted to iodide and reduces thyroid hormone secretion and vascularity
which beta blocker can treat hyperthyroidism
propanolol
why are calcium supplements used in hyperthyroidism
maintains normal bone density
what are the symptoms of hypothyroidism
autoimmune low metabolic rate slow speech deep hoarse voice lethargy bradycardia mental impairment skin thickening cretinism in children yellow skin nose thickening muscle pain bald patches constipation
what causes myxedema
increased hyaluronic acid and chondroitin sulfate in the dermis
swelling and puffiness of the subcutaneous tissue
what are the features of hypothyroidism
low T4 and maybe low t3
raised TSH unless pituitary problem
there may be anti thyroid antibodies
what are the causes of congenital hypothyroidism
hypoplasia familial enzyme defects iodine deficiency goitrogens during pregnancy pituitary defects idiopathic
may have few or no symptoms
must detect early in order to preserve IQ
what are the causes of acquired hypothyroidism
iodine deficiency autoimmune thyroidectomy radioiodide therapy TSH or TRH deficiency medications idiopathic
