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Endocrinology > 7 - General Thyroid Disorders > Flashcards

7 - General Thyroid Disorders Flashcards

1
Q

Which nerves go behind the thyroid?

A

Left recurrent laryngeal nerves.

If damaged their voice might change/ have difficulty speaking.

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2
Q

How much does the adult thyroid weigh?

A

20g.

Each lobe = 4 x 2.5 x 2.5 cm

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3
Q

How many lobes are there?

Which is the largest?

A

4 lobes.

Right is the largest.

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4
Q

What glands are found embedded in the thyroid?

A

Parathyroid glands.

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5
Q

Draw the thyroid gland.

A

Drawing

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6
Q

What is the origin of the thyroid gland?

A

Back of tongue

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7
Q

What is the foramen caecum?

A

Dimple at the back of the tongue (disappearing thyroglossal duct)

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8
Q

What is agenesis?

A

Agenesis - the failure of an organ to develop during embryonic growth.
= Complete absence of the thyroid gland.

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9
Q

What other problems with development of the thyroid could occur?

A
  • Incomplete descent (tongue to trachea)
  • Thyroglossal cyst (segment of duct presents as a lump)
  • Lingual thyroid (mass of thyroid at are of tongue)
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10
Q

What is a cretin?

A

An individual with irreversible brain damage caused by lack of thyroxine.

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11
Q

How is cretinism prevented?

A

Baby heel prick - blood test to measure TSH.

If TSH is high = thyroxine given.

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12
Q

Where is thyroxin synthesised?

A

Thyroid folicular cells

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13
Q

Draw a thyroid follicle cell.

A

Drawing

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14
Q

Where is thyroglobulin found?

A

Inside the thyroid gland ONLY.

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15
Q

What does thyroxine bind to in the circulation?

A

Thyroxine binding globulin. (75% of thyroxine is bound this way)

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16
Q

What do thyroid hormones regulate?

A

Growth, development and metabolic rate.

17
Q

What is the female:male ratio of thyroid disease?

A

4:1 - much more common in females.

18
Q

What is another name for primary hypothyroidism?

A

Myxoedema

19
Q

What is primary hypothyroidism?

A

Primary thyroid failure

  • Thyroxine levels fall
  • TSH levels rise (negative feedback)
20
Q

What can cause primary hypothyroidism?

A

Autoimmune damage

Operation

21
Q

Draw the HPT (hypothalamic-pituitary-thyroid axis)

A 
Drawing.
Hypothalamus - TRH
Pituitary - TSH released
Thyroid - T3 and T4 (thyroxine) released.
Negative feedback arrows.
22
Q

What does TRH stand for?

A

Thyrotropin releasing hormone.

23
Q

What does TSH stand for?

A

Thyroid stimulating hormone (thyrotropin)

24
Q

What are the features of primary hypothyroidism?

A
  • Deeper voice
  • Depression
  • Tiredness
  • Cold intolerance
  • Weight gain BUT reduced appetite
  • Constipation
  • Bradycardia (slow HR)
  • Eventual myxoedema coma.
25
Q

Why is treatment of hypothyroidism essential?

A

Patient will die

Cholesterol will rise - heart attack and stroke.

26
Q

How is hypothyroidism treated?

A

Replace thyroxine. 1 tablet daily.

Monitor TSH, adjust done until it is normal.

27
Q

What does an overactive thyroid gland do?

A

Make too much thyroxine.

28
Q

What is the name for an overactive thyroid gland?

A

Thyrotoxicosis/ Hyperthyroidism.

29
Q

What happens to TSH levels with hyperthyroidism?

A

They fall as the pituitary senses you have enough thyroxine.

30
Q

What happens to the metabolic rate with hyperthyroidism? What does this cause?

A

Raised metabolic rate.

  • Raised temperature
  • Burn calories quick & lose weight
  • Increased HR
31
Q

Symptoms of hyperthyroidism?

A
  • Myopathy (weak muscles)
  • Mood swings
  • Feeling hot
  • Diarrhoea
  • Increased appetite BUT weight loss
  • Hand tremor
  • Palpitations
  • Sore eyes
  • Goitre (lump in front of neck)
32
Q

What causes hyperthyroidism?

A

Graves’ disease - whole thyroid gland is smoothly enlarged & overactive.

33
Q

What causes Graves’ disease?

A

Autoimmune - antibodies bind to TSH receptor in thyroid.

Causes goitre and hyperthyroidism.

34
Q

What is exophthalmos and why is it caused by Graves’ disease?

A

Bulging of the eye out of its socket.

Cause - antibodies bind to muscles behind the eye.

35
Q

What is pretibial myxoedema and why is it caused by Graves’ disease?

A

The swelling of shins - growth of soft tissue.

Caused by antibodies.

36
Q

What is the difference between myxoedema coma and pretibial myxoedema?

A

Myxoedema coma - hypothyroidism (loss of brain function as a result of severe low level of thyroxine in the blood)

Pretibial myxoedema - hyperthyroidism (swelling of shins in Graves’ disease)

Endocrinology (18 decks)

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