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Flashcards in 0. Clinical Conditions Deck (12):


-enlargement of the thyroid gland
-may accompany either hypo or hyperthyroidism (but not necessarily present in either)
-develops when the thyroid gland is overstimulated



-too little thyroid hormone being produced

Causes: inadequate dietary supply of iodine, post surgery, anti thyroid drugs, autoimmune, deficiency of TSH or TRH, failure of the thyroid gland , radioactive iodine and congenital

General symptoms: obesity, lethargy, intolerance to cold, bradycardia, dry skin, alopecia, hoarse voice, constipation, slow reflexes, menorrhagia, puffy face, hands and feet 'peaches and cream face', memory problems, depression, psychosis (myxoedema madness)

Myxoedema - non pitting oedema due to deposition of mucopolysaccharides particularly around eyes, hands and feet.

Findings: Low T3 and Low T4, elevated TSH


Hashimoto's disease

-autoimmune disease
-resulting in destruction of thyroid follicles
-leading hypothyroidism
-most common disease of the thyroid gland
-5 times more common in women than men
-goitre may or may not be present

Findings: Plasma low T3, low T4, elevated TSH

Treatment: oral thyroid hormone - T4 used as longer half life . Normally 50-200 ug/day in single dose



Causes: autoimmune Grave's disease, toxic multinodular goitre, excessive T3 or T4 therapy, drugs - amiodarone, thyroid carcinoma, ectopic thyroid tissue

General symptoms: weight loss, irritability, heat intolerance - sweating and warm vasodilated hands, tachycardia, fatigue and weakness, increased bowel movements (and appetite), possible tremor of outstretched hands, breathlessness, hypereflexive , loss of libido

Some people may have goitre, and bulging eyes


Graves' disease

-autoimmune disease resulting in hyperthyroidism
-caused by production of thyroid stimulating immunoglobulin (TSI)
-TSI continuously stimulates thyroid hormone secretion outside normal negative feedback control

Findings: increased T3, increased T4, very low TSH

Symptoms: increase in BMR, excessive sweating, decrease in body weight, muscle weakness heart palpitations and bulging eyes (not every case)


Iodine deficiency

- particular concern during pregnancy
-if a mother is iodine deficient and hypothyroid then the foetus is also iodine deficient
This leads to a child with:

-mental retardation
-abnormal gait
-deaf mutism
-short stature


Thyroid cancer

-less than 1% of all thyroid nodules are malignant
-thyroid cancers do not cause metabolic disturbances (either hypo or hyperthyroid)
-presents as a thyroid nodule
-prognosis excellent 97% cure rate



-bruising easily
-breaking bones
-getting larger
-round red face
-buffalo hump back
-thin arms and legs
-trouble breathing



- very weak and tired
-feels sick
-cant get out of bed


Pituitary dwarfism

-growth hormone deficiency in childhood
-complete or partial deficiency
-both types respond to GH therapy
-height below the 3rd percentile on standard growth charts
-growth rate slower than expected for age
-delayed or no sexual development during teen years



- growth hormone excess in childhood
-often caused by a pituitary adenoma



-growth hormone excess, in adulthood leads to acromegaly
-literally means large extremities - hands, feet and lower jaw