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Endocrine (Zoe) > Hyperthyroidism > Flashcards

Hyperthyroidism Flashcards

1
Q

What kind of goitre do you get in graves disease?

A

Diffuse smooth goitre

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2
Q

What kind of goitre do you get in De Quevrins thyroditis?

A

Small tender goitre

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3
Q

What is the radio isotope uptake on graves?

A

Diffuse uptake

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4
Q

How do you treat a toxic adenoma or toxic multinodular goitre?

A

Radio iodine ablation

Surgery

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5
Q

What cells undergo hyperplasia in a toxic multinodular goitre?

A

Follicular cells

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6
Q

What antibodies do you get in graves disease?

A

Anti TSH receptor antibodies

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7
Q

What kind for hypersensitivity reaction is graves disease?

A

Type 2

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8
Q

What is the initial treatment of graves disease in patients under 50?

A

Anti thyroid drugs such as carbimazole or PTU

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9
Q

What is the best initial treatment for people over 50 with graves disease?

A

Surgery or radio iodine ablation

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10
Q

How does carbimazole work?

A

Inhibits thyroid peroxidase

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11
Q

What does thyroid peroxidase do?

A

Oxidises iodide ions to form iodine atoms for addition onto tyrosine residues on thyroglobulin

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12
Q

How does PTU work?

A

Oxidises iodide ions to form iodine atoms for addition onto tyrosine residues on thyroglobulin
Also inhibits the peripheral conversion of T4 to T3

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13
Q

What is the block and replace regiem?

A

High doses of carbomazole are given andthen once T4 is within the normal range thyroxine is given also.

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14
Q

When is the block and replace regiem contraindicated?

A

Pregnancy

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15
Q

What side effect does carbimazole cause?

A

Neutropenia. If sever can cause agranulocytosis

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16
Q

Describe the follow up of graves disease after 18 months?

A

Drugs are discontinued at 18 months and response measured

17
Q

How do you treat patients who relapse after stopping medication?

A

Definitive treatment such as surgery or radio iodine

Lifelong anti thyroid drugs if they cannot have this.

18
Q

How do you treat pre tibial myexodema?

A

Steroid ointment such as fluocinolone

19
Q

How do you treat a thyroid storm?

A 
HDU
IV paracetamol and cooling
Antiarrythmics
Treat underlying cause eg infection
Monitor glucose
Chloropromazine
PTU
Propanolol
Hydorcortisone
Pottassium iodide
20
Q

Why do you use hydrocortisone in a thyroid storm?

A

It inhibits the peripheral conversion of T4 - T3

21
Q

Why should you not give aspirin in a thyroid storm?

A

it displaces T4 from thyroid binding globulin

22
Q

Why do you need to monitor glucose in a thyroid storm?

A

A thyroid storm depletes liver glycogen stores

23
Q

How do you treat subacute and postpartum thyroiditis?

A

NSAIDs
Steroids ( 1 week prednisolone)
Propanolol

24
Q

What is amioderone?

A

An iodine containing anti arrhythmic drug

25
Q

How does amioderone affect thyroid function?

A

Inhibits conversion of T4 - T3 resulting in a high free T4, low T3 and a high TSH

Endocrine (Zoe) (12 decks)

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