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Endocrinology > Hyperthyroidism > Flashcards

Hyperthyroidism Flashcards

1
Q

another word for hyperthyroidism?

A

Thyrotoxicosis

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2
Q

Define thyrotoxicosis?

A

overactive thyroid gland

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3
Q

most common cause

A

Grave’s disease

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4
Q

is Grave’s a primary or secondary problem?

A

primary

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5
Q

90% of grave’s will have what autoantibody?

A

TSH receptor antibodies

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6
Q

which gender effected most by hyperthyroidism?

A

females

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7
Q

When only T3 increased what is it called?

A

toxicosis

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8
Q

really high thyroid hormone causes what emergency?

A

Thyroid Storm

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9
Q

explain pathophys of grave’s?

A

Anti-TSH antibodies stimulate TSH receptor on thyroid gland > ↑thyroid hormone

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10
Q

how does grave’s cause a goitre?

step by step

A

Anti-TSH antibodies > hit TSH receptor on thyroid glands > iodine influx into thyroid gland > thyroid cell hyperplasia > goitre made

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11
Q

↑thyroid hormone will do what to meatbolism and SNS?

A

↑

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12
Q

how can pituitary adenoma cause a goitre?

A

↑TSH > iodine influx into thyroid gland > thyroid cell hyperplasia > goitre made

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13
Q

hyperthyroidism:

what happens to weight?

A

Lose weight

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14
Q

hyperthyroidism:

what happens to mood?

A

Anxiety

Irritability

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15
Q

hyperthyroidism:

main symptom at skin?

A

Sweaty

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16
Q

hyperthyroidism:

main gut symptom?

A

Diarrhoea

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17
Q

hyperthyroidism:

heart symptoms?
-2

A

Palpitations

Arrhythmias AF

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18
Q

hyperthyroidism:

symptom only women can get?

A

Oligomenorrhea

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19
Q

define oligomenorrhea?

A

very few or light periods

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20
Q

oligos meaning?

A

small

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21
Q

hyperthyroidism symptoms?

-9

A 
Sweaty 
Lose weight
Diarrhoea
Irritability 
Anxiety 
Tremor 
Palpitations 
Arrhythmias AF
Oligomenorrhea
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22
Q

grave’ specific symptoms at the face?

-2

A

Eyes – exophthalmos, ophthalmoplegia

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23
Q

eye symptoms when you have grave’s disease is called what?

A

thyroid eye disease

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24
Q

why you get thyroid eye disease in grave’s disease?

A

• Anti-TSH antibodies react with orbital antigen > thyroid eye disease

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25
grave’ specific symptoms, what triad of symptoms can you get? what is this triad called?
clubbing, swollen hands and feet, new bone being made Thyroid acropachy
26
graves' dermopathy is aka what?
Pretibial myxedema
27
how does Pretibial myxedema look like on a pt?
swollen lower legs
28
Pituitary Adenoma can cause headaches. | why?
Pituitary adenoma stretches dura mater
29
Pituitary Adenoma can cause what visual field defect?
Bitemporal hemianopia
30
hyperthyroidism sign on neuro exam?
Hyperreflexia
31
hyperthyroidism of the eyes?
Lid Lag
32
pt has hyperthyroidism 1° thyroid problem will have what TFTs?
↑T4 ↑T3 ↓TSH
33
pt has hyperthyroidism 1° thyroid problem will have what TFTs?
↑T4 ↑T3 ↓TSH
34
pt has hyperthyroidism 2° thyroid problem will have what TFTs?
↑T4 ↑T3 ↑TSH =
35
↑T3 only is called what?
toxicosis
36
% wise how many hyperthyroidism are primary vs secondary?
99% are primary
37
define 1° thyroid problem?
problem at thryoid gland itself?
38
1° hyperthyroid problem. TSH levels?
↓TSH
39
1° hyperthyroid problem. T4 and T3 levels?
↑T4 ↑T3
40
2° hyperthyroid problem. TSH levels?
↑TSH
41
in 1° hyperthyroid problem why is TSH low?
negative feedback
42
you do blood test for antibodies in pt with Graves. main antibody in graves?
TSH receptor antibodies
43
you do blood test for antibodies in pt with Graves. 2nd most common antibody in graves? how many will have this antibody?
Anti-thyroid peroxidase antibodies 70%
44
you do blood test for antibodies in pt with Graves. 3rd most common antibody in graves? how many will have this antibody?
Anti-thyroglobulin 30%
45
Ix to look at iodine uptake in thyroid gland? | (what is it called?
Thyroid scintigraphy
46
Thyroid scintigraphy result in Grave's?
diffuse uptake of I-
47
Ix to check for goitre compression?
CT/MRI
48
best Ix to check for thyroid cancer?
fine-needle biopsy
49
bets Ix to check for Pituitary adenoma problem in suspected secondary hyperthyroidism?
MRI brain
50
glucose levels in hyperthyroidism? | up or down
up
51
pt has hyperthyroidism. why would you do ECG? what are you looking for?
ECG AF
52
pt has hyperthyroidism. has mild symptoms, drug given to stop tremor?
propranolol
53
pt has hyperthyroidism. cause is Grave's disease main drug given? -name
carbimazole
54
pt has Grave's disease. mainstay drug given? -name strength?
carbimazole 40mg
55
pt has Grave's disease. carbimazole not worked. 2nd line treatment?
radioiodine treatment
56
pt has Grave's disease radioiodine treatment not worked, still has symptoms. 3rd line treatment?
thyroidectomy
57
women is pregnant, has grave's disease. mainstay drugs given? -2 (names)
Propylthiouracil in 1st trimester then switch to carbimazole
58
pt has Thyroid eye disease. what do you give to treat these symptoms 1st line? -group
topical lubricants
59
pt has Thyroid eye disease. topical lubricants used, still has symptoms. 2nd line Mx? - 2 - one is drug class
steroids or orbital radiation
60
pt has hyperthyroidism, cause is thyroiditis. 1st Line Mx?
do nothing, | self-limiting ∴ treatment rarely needed
61
pt has hypothyroidism, cause is pituitary adenoma. main treatment?
radioiodine therapy
62
pt has hyperthyroidism, cause is Goitre . main treatment?
radioiodine therapy
63
outline 3 step Mx plan for Grave's disease?
1. Start carbimazole at 40 mg 2. Reduce dose gradually to maintain euthyroidism 3. Continue for 12-18 months
64
how many will relapse after the 3step Mx plan? | -% wise
50%
65
Carbimazole moa?
blocks thyroid peroxidase
66
blocking thyroid peroxidase does what exactly?
blocks iodination of thyroglobulin
67
Carbimazole main dangerous se?
agranulocytosis
68
Propylthiouracil moa?
blocks iodination of thyroglobulin
69
radioactive iodine is abbreviated to what?
I-131
70
Radioactive iodine therapy is contraindicated in what thyroid disease? why?
thyroid eye disease can make it worse
71
Thyroidectomy. 2 main risks?
risk of hypothyroidism risk of recurrent laryngeal nerve palsy
72
Radioactive iodine therapy has what ironic long term complication? what drug do you give to treat this?
hypothyroidism levothyroxine
73
female is going to have radioactive iodine therapy. what pt advice do you give her?
do not become pregnant for 6 months
74
how does I-131 help hyperthyroidism?
sticks to thyroid cancer cells or just thyroid cells, then radiation will kill these cells

Endocrinology (16 decks)

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