Hyperthyroidism, Hypothyroidism/Thyroiditis 1 Flashcards Preview

Endocrine week 3 > Hyperthyroidism, Hypothyroidism/Thyroiditis 1 > Flashcards

Flashcards in Hyperthyroidism, Hypothyroidism/Thyroiditis 1 Deck (18):
1

What are the primary causes of hypo and hyperthyroidism in general ?

Thyroid disease 

2

What are the secondary causes of hypo and hyperthyroidism in general ?

  • Hypothalmic disorders 
  • Pituitary disorders 

3

When measuring thyroid hormone levels what is measured?

  • TSH 
  • Free T3/T4

4

Describe the results for lab diagnosis of primary, secondary and sub-clinical hypothyroidism 

  • Primary - TSH High, T4/T3 low 
  • Sub-clinical - TSH high, T3/T4 normal 
  • Secondary - TSH low, T3/T4 low 

5

What is myxoedema?

It is swelling of the skin and underlying tissues due to accumulation of hydrophilic monosaccharides in the dermis and other tissues. Gives it a waxy consistency 

6

What is myxoedema most commonly associated with ?

Hypothyroidism 

 

7

What type of myxoedema is associated with hyperthyroidism ?

Pretibial myxoedema

8

What are the primary causes of hypothyroidism?

Goitres: 

  • Hashimotos thyroiditis (most common)
  • Iodine deficiency 

 

Non-goitrous:

  • Congenital developmental defect 
  • Atrophic thyroiditis 
  • Post-ablative (radio/surgery)
  • Self-limiting (following withdrawal of suppressive therapy)

 

 

9

How does Hashimotos thyroiditis cause hypothyroidism and what is it characterised by ?

Causes autoimmune destruction of thyroid gland ==> reduced thyroid hormone production 

Characterised by:

  • Presence of thyroid peroxidase antibodies. (TPO)
  • T-cell infiltration and inflammation on microscopy

10

Describe the progression of hypothyroidism in terms of the thyroid hormones 

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11

What are the symptoms of hypothyroidism ?

  • Fatigue/muscle weakness 
  • Increased sensitivity to cold
  • Constipation 
  • Dry skin 
  • Unexpected weight gain 
  • Puffy face 
  • Hoarseness 
  • Elevated cholesterol 
  • Muscle aches and pains
  • Pain, stiffness or swelling in your joints 
  • Heavier than normal or irregular menstrual periods 
  • Thinner hair 
  • Slower HR 
  • Depressed moods 
  • Impaired memory 

12

What are the further lab results of someone with hypothyroidism ?

  • TSH high 
  • T4/T3 low 
  • Elevated creatinine (CK)
  • Increased LDL
  • Hyperprolactinaemia 

13

Go over the thyroid antibodies 

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14

What is the treatment of hypothyroidism ?

Thyroxine (T4) - levothyroxine 

Note - normal metabolic rate should be restored slowly as it can precipitate arrhythmias 

15

What is myxoedema coma ?

It is loss of brain function as a result of severe longstanding hypothyroidism

16

What are the symptoms of myxoedema coma ?

  • Body temp may be as low as 26.6 
  • Severe mental changes including hallucinations, disorientation, seizures, and ultimately deep coma 

17

What is the treatment of myxoedema coma ?

  • Give T3 as faster acting - liothyronine 
  • Give hydrocortisone 
  • Rehydrate 
  • If caused by infection then antibiotics 
  •  

18

Who does myxoedema typically affect?

Elderly women with long standing but frequently unrecognised or untreated hypothyroidism