Flashcards in Hypo/hyperthyroidism Deck (58):
Give 2 secondary causes of hypo/hyperthyroidism?
What would you want to measure if you thought a patient has hyperthyroidism?
thyroid function tests
also do ECG in case of AF
What is pretibial myoxoedema? When is it seen?
accumulation of mucopolysaccharides in ground substance of dermis on skin of shins
What is thyrotoxicosis?
When does myoexedema occur?
Either refers to severe hypothyroidism eg myoexedema coma
OR pretibial myoxoedema in Grave's disease - on skin
In areas of high iodine intake, is hypo or hyper more common?
What are the goitrous causes of primary hypothyroidism?
Chronic thyroiditis (Hashimotos)
What are the non goitrous causes of hypothyroidism?
Most common cause of thyroiditis?
In Hashimotos, what is seen in blood?
thyroid peroxidase antibodies
In Hashimotos, what is seen on microscopy?
T cell infiltrate and inflammation
What type of hair can be seen in hypothyroidism?
What are other signs of hypothyroidism?
dull expressionless face
pale cool skin, doughy to touch
fluid retention, pitting oedemia
Can vitiligo be associated with hypo or hyper?
What happens to heart rate in hypo?
What happens to lipids in hypo?
What respiratory signs may occur with hypo
deep hoarse voice, macroglossia, obstructive sleep apnoea
What GI symptoms may occur with hypo?
What is carpal tunnel more likely in, hypothyroid or hyperthyroid?
What can hypothyroidism do to periods?
What does hypothyroid do to prolactin?
What happens to thyroid hormones in hypothyroid?
What happens to sodium in hypothyroidism?
Once stabilized, how often should TSH be checked?
every 12-18 months
What is the main treatment of hypothy.
Is there any benefit of combined T4 and T3 therapy?
When is T4 preferabnly taken?
Is T3 therapy used much in hypo?
Who does myxoedema coma tend to affect?
elderly women with longstanding but untreated hypothyroidism
Is there a high mortality in myxoedema coma?
What are the ECG findings of myxoedema coma?
bradycardia, low voltage complexes, varying degrees of heart block, t wave inversion, prolongation of QT interval
Which drug can cause thyroid dysfuction?
Is it more likely to get hypo or hyper on amiodarone?
Cardiac signs of hyperth?
cardiac failure (rare)
What CNS symptoms may occur in hyperth?
anxiety, irritability, insomnia
What GI symptoms may occur in hyperth?
frequent loose bowel movements
What may happen to vision in hyperth?
eyes that bulge out
What hair changes occur in hyperthyroidism?
brittle thinning hair
What happens to nail growth in hyperthyroid?
What happens to periods in hyperthyroidism?
lighter bleeding/less frequent
What happens to muscles in hyperth?
weakness, especially in thighs and upper arms
What happens to metabolism in hyper?
increased appetite but weight loss
What are nodular thyroid causes of hyperthyroid?
multi nodular goiter
toxic nodule (adenoma)
What are inflammatory types of hyperthyroid?
What is seen on thyroid function tests in Grave's?
high T3/4, low TSH
What is Graves antibody positive for?
What is seen on ultrasound in graves?
smooth symmetrical goitre
In whom does nodular thyroid disease occur more?
Are nodular thyroid disease patients antibody TRAbs positive?
What type of goiter is seen in in nodular thyroid disease?
What is De Quervains?
sub acute thyroiditis
What happens to T4 in sub acute thyroiditis?
high then low then normal
What happens to TSH in sub acute thyroiditis?
low then high then normal
What is Thyroid storm?
resp and cardio collapse
may be linked to infection
What is treatment of thyroid storm?
lugols iodine, glucocorticoids, PTU, B blockers, fluids, monitoring
Treatment of hyperthyroidism?
propylthiouracil (preferred in pregnancy)
What else should be used in hyperthyroid to treat symptoms?