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RB Y2 Endocrine - 2 Thyroid > Hyperthryoidism > Flashcards

Hyperthryoidism Flashcards

1
Q

thyrotoxicosis

A

clinical, pysiological and biochemical state arising when the tissues are exposed to excess thyroid hormones

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2
Q

hyperthyroidism

A

refers specifically to conditions in which over activity of the thyroid glands leads to thyrotoxicosis

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3
Q

heart

A

force and rate increased as TH increase the responsiveness of receptors to catecholamines (adrenaline and noradrenaline)

patients may also suffer from tachycardia and atrial fibrillation

rarely, cardiac failure

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4
Q

what is used to treat heart symptoms

A

B blockers eg propanolol

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5
Q

heat

A

thermogenesis is 30% due to thyroid hormones - increase in secretion results in heat intolerance

complications may arise from this, patients may also have moist, itchy skin

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6
Q

movement

A

tremor, especially in the hands. due to effects of thyroid hormones on CNS

hyperkinesis - excessive bodily movement

muscle weakness, especially thighs and upper arms

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7
Q

basal metabolic rate

A

increases (growth hormone) meaning patients will have bigger appetites and a tendency to lose weight

the metabolic rates of proteins, fats and carbohydrates are boosted

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8
Q

what cellular changes occur with increased BMR

A

increase in number and size of mitochondria

increased oxygen use and rate of ATP hydrolysis

increased synthesis of respiratory chain enzymes

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9
Q

sleep

A

patient may find it difficult to sleep as they are constantly agitated and irritable

may also have lots of energy at night

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10
Q

menstrual cycle

A

irregular (oligomenorrhoea) and may also complain of loss of libido

light bleeding and less frequent periods, they can disappear completely

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11
Q

behaviour

A

tremor

agitation - feeling on edge

apparent restlessness

behavioural changes - emotional lability

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12
Q

GI

A

Diarrhoea

frequent, loose bowel movements

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13
Q

vision

A

lid retraction

double vision

thyroid eye disease

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14
Q

medical term for double vision

A

diploplia

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15
Q

hair and skin

A

hair becomes brittle and thin

rapid fingernail growth

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16
Q

normal TSH and TH levels

A

TSH: 0.4-4.0 mU/L

T3: 9.9-22

fT4: 0.9-2.6

17
Q

goitre

A

enlargment of the thyroid gland

18
Q

causes of goitre

A

iodine deficiency, hypo and hyper thryoidism, Grave’s disease

nodular causes: adenoma, carcinoma and TMNG

19
Q

what can goitre cause

A

compression of local structures - difficulties breathing and swallowing

20
Q

DeQuervain’s thyroiditis

A
  • transient (self-limiting) hyperthryoidism from an acute inflammatory process (probably viral in origin)
  • there is usually fever, malaise and pain in the neck with tachycardia and local thyroid tenderness
21
Q

outline the 4 phases of De Quervain’s thyroiditis

A
  1. (3-6 weeks): hyperthyroidism, painful goitre, raised ESR
  2. (1-3 weeks): euthyroid
  3. (weeks-months): hypothyroidism
  4. Thyroid structure and function returns to normal
22
Q

treatment of DeQuervain’s thyroiditis

A

acute phase - aspirin

short term prednisolone in severely symptomatic cases

23
Q

other causes of thyroiditis

(which drugs +)

A

post partum

drug induced eg amiodarone

24
Q

other causes of thyrotoxicosis not associated with hyperthyroidism

A

exogenous thyroid hormones: over treatment with levothyroxine or thyrotoxicosis factiita (self/deliberate poisoning)

rarely, ectopic thyroid tissue:

  • metastatic thyroid carcinoma
  • struma ovarii - ovarian teratoma containing thyroid tissue
25
Q

what drugs can the production of thyroid hormones be inhibited by

A

carbimazole and proplythiouracil (PTU)

work by inhibiting the attachment of iodine to tyrosine residues on thryoglobulin to from MIT and DIT

26
Q

how are CBZ and PTU started

A

intitially at a high dose and then gradually reduced over the course of 12-18 months

27
Q

side effects of CBZ

A

risk of agranulocytosis (dramatically lowered neutrophils, can lead to dangerous sepsis)

  • if the patient develops a dry cough/sore throat the medication must be stopped immediately
  • risk is highest within the first 6 weeks of being on the drug
28
Q

what medication is given to treat the heart problems associated

A

atrial fibrillation and tachycardia

  • ß blockers eg propanolol
29
Q

radio iodine

A

use of radioactive iodine 131 can suppress excretion of exces hormone

one off oral dose to destroy cells within the thyroid gland

30
Q

what often happens post radio iodine treatment

A

become hypothyroid - managed with medication

can also precipitate a thyroid storm

31
Q

what is the usually cause of a painful neck swelling and hyperthyroidism

A

thyroidits

RB Y2 Endocrine - 2 Thyroid (8 decks)

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