Presentation and management of hypo/hyperthyroidism Flashcards
What are the most common endocrine disorders?
Thyroid diseases
How many times greater are there females with thyroid disease than males?
5-10 fold
What are the prevalence of hyperthyroidism, hypothyroidism and goitre?
- Hyperthyroidism 2.5% prevalence
- Hypothyroidism 5%
- Goitre 5-15%
What are examples of thyroid autoimmunity?
- Focal thyroiditis and/or positive TPO and thyroglobulin antibodies
- Postpartum thyroiditis
- Autoimmune hypothyroidism
- Graves’ disease
What are examples of autoimmune hypothyroidism?
- Hashimoto’s thyroiditis
- Atrophic thyroiditis
What happens in Graves’ disease?
Thyroid associated ophthalmopathy
What is found in almost all patients with autoimmune hypothyroidism?
Thyroglobulin and thyroid peroxidase (TPO) antibodies
Where are thyroglobulin and thyroid peroxidase (TPO) antibodies also found?
- Also present in 75% Graves’ patients
- Low levels present in healthy individuals at risk of thyroid or other autoimmune disease
What mediates the destruction of thyroid cells?
Cytotoxic (CD8+) T cell-mediated
What is goitre?
- Palpable & visible thyroid enlargement
- Variety of causes
- Commonly sporadic or autoimmune
- Endemic in iodine deficient areas
- Thyroid tries to compensate and goes through hyperplastic change
Define hyperthyroidism
excess of thyroid hormones in blood
What are the 3 mechanisms for increased thyroid hormone?
- overproduction thyroid hormone
- leakage of preformed hormone from thyroid
- ingestion of excess thyroid hormone
What are causes of hyperthyroidism?
- Common
- Graves’ disease (75- 80% of all
cases) - Toxic multinodular goitre
- Toxic adenoma
- Congenital hyperthyroidism
- Thyroiditis
(subacute/silent/postpartum)
- Graves’ disease (75- 80% of all
Which drugs could cause hyperthyroidism?
- Iodine
- Amiodarone
- Lithium?
- Radiocontrast agents
What are clinical features of hyperthyroidism?
- Wt loss
- Tachycardia
- Hyperphagia
- Anxiety
- Tremor
- Heat intolerance
- Sweating
- Diarrhoea
- Lid lag + stare
- Menstrual disturbance
- Heavy periods