Hyper and hypothyroidism

Question 1

Hyperthyroidism and symptoms:

Answer 1

High T4
Low TSH

Excessive sweating
Palpitations
Hair loss
Weight loss
Nervous

Question 2

Hypothyroidism and symptoms:

Answer 2

High TSH
Low T4

Weight gain
Mood changes
Tiredness
Dry skin

Question 3

Treatment of hyper

Answer 3

1. Carbimazole
2. Propylthiouracil

Other drugs
Iodine
Radioactive sodium iodide
Propanolol

Question 4

Blocking replacement regimen

anti-thyroid drugs can cause hypo, this helps balance levels out

Answer 4

Carbimazole + Levo

• avoid in pregnancy (fetal goitre)

Question 5

Thyrotoxic crisis (storm)

Answer 5

Overactive thyroid - med emergency

I.V. fluids
Propanolol
Hydrocortisone
Oral carbimazole or propylthiouracil

Question 6

Pregnancy:

Answer 6

1st trimester: propylthio
2nd trimester: carbim
(due to the risk of hepatox with propyl)

Question 7

Carbimazole

Answer 7

Neutropenia and agranulocytosis
Bone marrow suppression
Symptoms include:
Sore throat, ulcers, bruising, fever
Perform WBC and stop if neutropenia is confirmed

Question 8

Propylthiouracil

Answer 8

Hepatotoxic - discontinue if severe signs of liver disorder

Question 9

Thyroid hormones

Answer 9

Liothyronine - (rapidly effects/metabolised - severe states)

Levothyroxine - maintenance

Question 10

Levothyroxine

Answer 10

At least 30 minutes before breakfast, caffeine containing drinks or other medicines