Throid Disease

Question 1

what is excess thyroid hormone known as?

Answer 1

hyperthyroidism

Question 2

what is meant by PRIMARY endocrine disease?

Answer 2

gland failure

Question 3

what is meant by SECONDARY endocrine disease?

Answer 3

control failure

Question 4

what is a deficiency of thyroid hormone known as?

Answer 4

hypothyroidism (also myxoedema)

Question 5

what disease causes majority of hyperthyroidism cases?

Answer 5

Graves’ disease

Question 6

what is Graves’ disease?

Answer 6

• organ specific autoimmune disease

Question 7

how does Graves’ disease cause hyperthyroidism?

Answer 7

• body produces an antibody that is similar to the TSH receptor
• antibody binds the TSH receptor on the thyroid gland
• TSH receptor thinks that TSH has bound
• stimulated thyroid gland to release more hormone

Question 8

how can a toxic adenoma cause hyperthyroidism?

Answer 8

tumour within the thyroid gland over-produces the hormone in an unregulated way

Question 9

what are the signs of hyperthyroidism?

Answer 9

• warm moist skin
• tachycardia & atrial fibrillation
• increased BP & heart failure
• tremor
• eyelid retraction and lid lag

Question 10

what are symptoms a patient suffering from hyperthyroidism will experience?

Answer 10

• hot and excess sweating
• weigh loss
• diarrhoea
• palpitations
• irritable, manic, anxious
• muscle weakness

Question 11

what are clinical signs that a patient is suffering with Graves’ disease?

Answer 11

• goitre (swelling of thyroid gland)
• proptosis (eyeballs pushed forward)
• periorbital oedema (swelling around eyes)

Question 12

what may cause primary Hypothyroidism?

Answer 12

• Hashimoto’s disease (autoimmune thyroiditis)
• Idiopathic atrophy
• Radioiodine treatment/thyroidectomy surgery
• iodine deficiency
• drugs
• congenital

Question 13

what occurs to a patient suffering from Hashimotos disease?

Answer 13

• body produces an antibody which attacks the thyroid gland
• causes inflammation of the gland
• gradual fibrosis and destruction of the specialised thyroid tissue

Question 14

what is a secondary cause of Hypothyroidism?

Answer 14

hypothalamic/pituitary disease

Question 15

what are the signs of hypothyroidism?

Answer 15

• dry coarse skin
• bradycardia, hyperlipidaemia
• psychiatric or confusion
• goitre (hashimotos)
• delayed reflexes

Question 16

in a patient suffering with Hypothyroidism, what symptoms may they present with?

Answer 16

• tired
• cold intolerance
• weight gain
• constipation
• goitre and puffed face & extremities
• angina
• hair loss (eyebrows)

Question 17

who is most likely to suffer from Hashimoto’s Thyroiditis?

Answer 17

middle aged & elderly women

Question 18

what investigations may be carried out in a patient with suspected Thyroid Disease?

Answer 18

• blood tests
• imaging
• tissue biopsy

Question 19

what blood tests may be undertaken when investigating thyroid disease?

Answer 19

looking at levels of:

• TSH (thyroid stimulating hormone)
• T3 and T4

Question 20

what imaging tests may be done when investigating thyroid disease?

Answer 20

• ultrasound scan (cysts)

- radioisotope scans (gland uptake)

Question 21

what type of tissue biopsies may be done when investigating Thyroid Disease?

Answer 21

• fine needle aspirate (FNA)

- fine needle biopsy (FNB)

Question 22

explain the hormone levels (of TSH and T3/4) in a patient suffering with Hyperthyroidism caused by the pituitary:

Answer 22

• raised TSH

- raised T3

Question 23

explain the hormone levels of a patient suffering with Hyperthyroidism caused by Graves’ disease or an adenoma?

Answer 23

• low TSH

- raised T3

Question 24

explain the hormone levels of a patient suffering with Hypothyroidism caused by the pituitary:

Answer 24

• low TSH

- low T4

Question 25

explain the hormone levels of a patient suffering with Hypothyroidism caused by gland failure (Hashimoto’s):

Answer 25

• high TSH

- low T4

Question 26

what are the treatment options for a patient suffering from Hyperthyroidism?

Answer 26

• carbimazole
• beta blockers
• radioiodine
• surgery (partial thyroidectomy)

Question 27

why might beta blockers be given to a patient suffering with Hyperthyroidism?

Answer 27

to reduce anxiety, tremors and palpitations

Question 28

what are the treatment options for a patient suffering with Hypothyroidism?

Answer 28

give T4 tablets (thyroxine)

Question 29

what may thyroid swelling be suggestive of?

Answer 29

thyroid cancer

Question 30

in dentistry, if a patient is suffering from Hypothyroidism what may need to be avoided?

Answer 30

the use of sedatives if their hypothyroidism is severe