Hyperthyroidism and Hypothyroidism Flashcards

1
Q

what causes primary thyroid disease?

A

a problem with the thyroid itself

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2
Q

what is the most common cause of primary thyroid disease?

A

autoimmune diseases

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3
Q

what TFT’s are seen in primary hypothyroidism?

A

low T3/4

high TSH

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4
Q

what TFT’s are seen in primary hyperthyroidism?

A

high T3/4

low TSH

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5
Q

what TFT’s are seen in secondary hypothyroidism?

A

low T3/4

low TSH

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6
Q

what TFT’s are seen in secondary hyperthyroidism?

A

high T3/4

high TSH

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7
Q

what causes secondary thyroid disease?

A

problems with the hypothalamus or pituitary

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8
Q

what is another name for TSH?

A

thyrotropin

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9
Q

which is more abundant - T3 or T4?

A

T4

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10
Q

what is myxoedema?

A

very severe hypothyroidism

an emergency

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11
Q

what is pretibial myxoedema?

A

a rare sign of Grave’s disease

not associated with hypothyroidism

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12
Q

what causes pretibial myxoedema?

A

build up of GAGs within the collagen

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13
Q

what is the most common cause of primary hypothyroidism?

A

hashimoto’s thyroiditis

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14
Q

what is hashimoto’s thyroiditis?

A

autoimmune destruction of the thyroid gland causing reduced thyroid hormone production

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15
Q

who is most commonly affected by hashimoto’s thyroiditis?

A

women

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16
Q

what antibodies are produced in hashimoto’s thyroiditis?

A

antibodies against thyroid peroxidase

17
Q

what is the management for hypothyroidism?

A

levothyroxine

18
Q

who is the typical patient affected by myxoedema coma?

A

elderly women with longstanding but untreated hypothyroidism

19
Q

what is thyrotoxicosis?

A

the clinical state arising when the tissues are exposed to excess thyroid hormone

20
Q

what is hyperthyroidism?

A

conditions that lead to thyrotoxicosis

21
Q

who is more commonly affected by grave’s disease?

A

women

22
Q

what is an important risk factor for grave’s disease?

A

smoking

23
Q

what is the first line drug for hyperthyroidism?

A

carbimazole

24
Q

when is propylthiouracil first line for hyperthyroidism?

A

only in the first trimester of pregnancy

25
Q

what is a rare but serious potential complication of anti-thyroid drugs?

A

agranulocytosis

26
Q

what is the first line beta blocker considered for hyperthyroidism?

A

propranolol

used for immediate symptomatic relief

27
Q

what is the first line management for relapsed grave’s disease and nodular thyroid disease?

A

radioiodine

28
Q

when is radioiodine contraindicated?

A

in pregnancy

active thyroid eye disease - can be given with steroid cover

29
Q

what is thyroiditis?

A

inflammation of the thyroid

30
Q

name two drugs that could potentially cause thyroiditis

A

amiodarone

lithium

31
Q

what blood results are seen in subclinical hypothyroidism?

A

raised TSH

normal T3/T4

32
Q

when is treatment recommended for subclinical hypothyroidism?

A

TSH >10

in pregnancy

33
Q

what blood results are seen in subclinical hyperthyroidism?

A

low TSH

normal T3/T4

34
Q

what conditions can subclinical hyperthyroidism be associated with?

A

multinodular goitre
osteoporosis
AF

35
Q

when is treatment advised for subclinical hyperthyroidism?

A

TSH <0.1

or if co-existing osteoporosis/AF

36
Q

what is another name for non-thyroidal illness?

A

sick euthyroid syndrome

37
Q

who is often affected by sick euthyroid syndrome?

A

unwell hospitalised patients

38
Q

what does sick euthyroid syndrome refer to?

A

the impact of intercurrent illness on the HPT axis

39
Q

describe the thyroid hormone levels seen in sick euthyroid syndrome

A

TSH suppressed initially, rises during recovery