Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrinology > Hypo + Hyperthyroidism > Flashcards

Hypo + Hyperthyroidism Flashcards

1
Q

What are the TSH and T4 levels in Graves Disease?

A

TSH low
T4 high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the TSH and T4 levels in primary hypothyroidism?

A

TSH high
T4 low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the TSH and T4 levels in primary hyperthyroidism?

A

TSH low
T4 high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the TSH and T4 levels in secondary hyperthyroidism?

A

TSH high
T4 high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the TSH and T4 levels in secondary hypothyroidism?

A

TSH low
T4 low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which antibodies are responsible for Graves’ disease?

A

TSH receptor antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which conditions have anti-tpo antibodies? (2)

A

Graves’ disease
Hashimotos thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which 3 conditions have anti-tg antibodies?

A

Graves
Hashimotos
Thyroid camcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which 2 antibodies are present in Hashimotos thyroiditis?

A

Anti-tpo
Anti-tg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Diffuse high uptake is seen on radioactive iodine scan. What does this suggest?

A

Graves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Focal high uptake is seen on a radioactive iodine scan. What does this suggest?(2)

A

Toxic multinodulae goitre
Adenomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cold areas are seen on a radioactive iodine scan. What does this suggest?

A

Thyroid cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is secondary hyperthyroidism usually caused by?

A

Pituitary adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is sub clinical hyperthyroidism?

A

where the thyroid hormones (T3 and T4) are normal and thyroid-stimulating hormone (TSH) is suppressed (low). There may be absent or mild symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the causes of hyperthyroidism? (4)

A

GIST

• G – Graves’ disease
• I – Inflammation (thyroiditis)
• S – Solitary toxic thyroid nodule
• T – Toxic multinodular goitre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 4 types of thyroiditis?

A

○ De Quervain’s thyroiditis
○ Hashimoto’s thyroiditis
○ Postpartum thyroiditis
○ Drug-induced thyroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What type of thyroidism does thyroiditis cause?

A

Initial period of hyperthyroidism
Followed by hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the nodules in solitary toxic thyroid nodules usually?

A

Benign adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is toxic multinodular goitre most common?

A

Over 50 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In what conditions is thyroid function regularly tested in? (4)

A

○ Type 1 diabetes
○ Other autoimmune disease
○ New onset AF
○ Depression and anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What triad of symptoms is seen in thyroid storm?

A

Fever
Tachycardia
Delirium

22
Q

What management is used in thyroid storm? (5)

A

• Beta blockers, anti-arrhythmics
• Fluids
• Thioamides = typically propylthiouracil, which has antithyroid effects and reduces conversion of T4 to T3
• Corticosteroids = reduce conversion of T4 to T3
• Lugol’s iodine

23
Q

What is Lugols iodine and when is it typically used?

A

Aqueous iodine oral solution
Usually 4hrs after anti thyroid therapy in a thyroid storm

24
Q

What are some symptoms of hyperthyroidism? (15)

A

• Anxiety and irritability
• Sweating and heat intolerance
• Tachycardia
• Weight loss
• Fatigue
• Insomnia
• Frequent loose stools - diarrhoea
• Sexual dysfunction
• Brisk reflexes on examination
• Fine tremor
• Palpitations
• Amenorrhoea
• Gynaecomastia (in men)
• Change in mood
Hair loss

25
Q

What is pretibial myxoedema and when is it seen?

A

○ a skin condition caused by deposits of glycosaminoglycans under the skin on the anterior aspect of the leg (the pre-tibial area). It gives the skin a discoloured, waxy, oedematous appearance over this area. It is specific to Grave’s disease and is a reaction to TSH receptor antibodies.

26
Q

What signs are seen specifically in Graves’ disease?

A

Exophthalmus
Pretibial myxoedema
Thyroid acropachy (hand swelling and finger clubbing)
Thyroid bruit

27
Q

What is the first line treatment of hyperthyroidism?

A

Carbimazole

28
Q

What are the 2 regimes available for Carbimazole?

A

• Block and replace = give at sufficient levels to block endogenous T3/T4 then give levothyroxine
• Dose titration = given alone, then dose adjusted to give normal levels of TSH

29
Q

What is a side effect of Carbimazole? What is a side effect of propylthiouracil? And what is a side effect of both of these drugs?

A

Carbimazole = pancreatitis
Propylthiouracil = severe liver reactions
Both = agranulocytosis (look out for sore throat)

30
Q

When is propylthiouracil used instead of Carbimazole? (3)

A

○ Intolerant/allergic to carbimazole
○ Pregnant/planning on pregnancy in 6months
○ A history of pancreatitis

31
Q

What are the rules for radioactive iodine treatment? (3)

A

• Women must not be pregnant or breastfeeding and must not get pregnant within 6 months of treatment
• Men must not father children within 4 months of treatment
• Limit contact with people after the dose, particularly children and pregnant women

32
Q

What is a side effect of radioactive iodine treatment for hyperthyroidism?

A

Hypothyroidism - need levothyroxine

33
Q

What is used to manage symptoms of hyperthyroidism?

A

Beta blockers
Usually propranolol as it’s non selective

34
Q

What are some complications of a thyroidectomy? (3)

A

Hypothyroidism
Hypocalcaemia as can get parathyroid glands on accident
Recurrent laryngeal nerve injury - hoarse voice

35
Q

What is primary hypothyroidism?

A

Primary hypothyroidism = thyroid behaves abnormally and produces inadequate thyroid hormones. Negative feedback is absent, resulting in increased production of TSH. TSH is raised, and T3 and T4 are low.

36
Q

What is secondary hypothyroidism?

A

Secondary hypothyroidism (central hypothyroidism) = where the pituitary behaves abnormally and produces inadequate TSH, resulting in under-stimulation of the thyroid gland and insufficient thyroid hormones. TSH, T3 and T4 will all be low.

37
Q

What is the most common cause of hypothyroidism in the developed world? Developing world?

A

Developed = Hashimotos thyroiditis
Developing = iodine deficiency

38
Q

What 2 drugs can cause hypothyroidism?

A

Lithium - inhibits thyroid hormone production
Amiodarone

39
Q

What are some causes of secondary hypothyroidism? (5)

A

• Tumours (e.g., pituitary adenomas)
• Surgery to the pituitary
• Radiotherapy
• Sheehan’s syndrome (where major post-partum haemorrhage causes avascular necrosis of the pituitary gland)
• Trauma

40
Q

What is Sheehan’s syndrome?

A

where major post-partum haemorrhage causes avascular necrosis of the pituitary gland

41
Q

What are some symptoms of hypothyroidism? (10)

A

• Weight gain
• Fatigue
• Dry skin
• Coarse hair and hair loss
• Fluid retention (including oedema, pleural effusions and ascites)
• Heavy or irregular periods
• Constipation
• Cold intolerance
• Menstrual irregularities
• Reduced libido

42
Q

What are some signs of hypothyroidism?(6)

A

• Hair loss (particularly the outer 3rd of eyebrow)
• Dry skin
• Goitre
• Bradycardia
• Myxoedema
• Delayed relaxation phase of deep tendon reflexes

43
Q

What is the management of hypothyroidism?

A

Oral levothyroxine is the mainstay of treatment of hypothyroidism. Levothyroxine is a synthetic version of T4 and metabolises to T3 in the body.

44
Q

What is TSH result if the levothyroxine dose is too high? Too low?

A

Too high = TSH will be low
Too low = TSH will be high

45
Q

What can be used if levothyroxine is not tolerated?

A

Liothyronine sodium is a synthetic version of T3 and is very rarely used under specialist care where levothyroxine is not tolerated.

46
Q

What is the presentation of myxoedema coma? (4)

A

○ Hypotensive
○ Hypothermic
○ Bradycardic
○ Cognitive decline

47
Q

What is the management of myxoedema coma? (3)

A

○ IV levothyroxine
○ Electrolyte imbalances and hypothermia should be addressed
○ IV hydrocortisone may be needed unless hypopituitarism is ruled out as cause

48
Q

What is the triad of signs for Hashimotos thyroiditis?

A

Hypothyroidism
Goitre
Anti-tpo

49
Q

What chromosomes are associated with Hashimotos thyroiditis?

A

2 and 8

50
Q

What are the 3 phases of de quervains thyroiditis?

A

• Thyrotoxicosis
• Hypothyroidism
• Return to normal

51
Q

What is the management of de quervains thyroiditis? (3)

A

It is a self-limiting condition, and supportive treatment is usually all that is necessary. This may involve:
• NSAIDs for symptoms of pain and inflammation
• Beta blockers for the symptoms of hyperthyroidism
• Levothyroxine for the symptoms of hypothyroidism

Endocrinology (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions