Hypo/hyperthyroidism Flashcards Preview

Endocrinology > Hypo/hyperthyroidism > Flashcards

Flashcards in Hypo/hyperthyroidism Deck (58):
1

Give 2 secondary causes of hypo/hyperthyroidism?

hypothalamic
pituitary

2

What would you want to measure if you thought a patient has hyperthyroidism?

thyroid function tests
also do ECG in case of AF

3

What is pretibial myoxoedema? When is it seen?

accumulation of mucopolysaccharides in ground substance of dermis on skin of shins
Grave's disease

4

What is thyrotoxicosis?

hyperthyroidism

5

When does myoexedema occur?

Either refers to severe hypothyroidism eg myoexedema coma
OR pretibial myoxoedema in Grave's disease - on skin

6

In areas of high iodine intake, is hypo or hyper more common?

hypo

7

What are the goitrous causes of primary hypothyroidism?

Chronic thyroiditis (Hashimotos)
Iodine deficiency

8

What are the non goitrous causes of hypothyroidism?

atrophic thyroiditis
post ablative/radiotherapy
congenital

9

Most common cause of thyroiditis?

hashimoto's

10

In Hashimotos, what is seen in blood?

thyroid peroxidase antibodies

11

In Hashimotos, what is seen on microscopy?

T cell infiltrate and inflammation

12

What type of hair can be seen in hypothyroidism?

sparse, coarse

13

What are other signs of hypothyroidism?

dull expressionless face
periorbital puffiness
pale cool skin, doughy to touch
vitiligo
hypercarotenaemia/yellowing
fluid retention, pitting oedemia

14

Can vitiligo be associated with hypo or hyper?

hypo

15

What happens to heart rate in hypo?

reduced

16

What happens to lipids in hypo?

hyperlipidaemia

17

What respiratory signs may occur with hypo

deep hoarse voice, macroglossia, obstructive sleep apnoea

18

What GI symptoms may occur with hypo?

constipation

19

What is carpal tunnel more likely in, hypothyroid or hyperthyroid?

hypo

20

What can hypothyroidism do to periods?

menorrhagia
later oligo/amenorrhoea

21

What does hypothyroid do to prolactin?

increases

22

What happens to thyroid hormones in hypothyroid?

TSH high
T4/3 low

23

What happens to sodium in hypothyroidism?

low

24

Once stabilized, how often should TSH be checked?

every 12-18 months

25

What is the main treatment of hypothy.

thyroxine

26

Is there any benefit of combined T4 and T3 therapy?

no

27

When is T4 preferabnly taken?

before breakfast

28

Is T3 therapy used much in hypo?

no

29

Who does myxoedema coma tend to affect?

elderly women with longstanding but untreated hypothyroidism

30

Is there a high mortality in myxoedema coma?

yes

31

What are the ECG findings of myxoedema coma?

bradycardia, low voltage complexes, varying degrees of heart block, t wave inversion, prolongation of QT interval

32

Which drug can cause thyroid dysfuction?

amiodarone

33

Is it more likely to get hypo or hyper on amiodarone?

hypo

34

Cardiac signs of hyperth?

palpatations/AF
cardiac failure (rare)

35

What CNS symptoms may occur in hyperth?

anxiety, irritability, insomnia

36

What GI symptoms may occur in hyperth?

frequent loose bowel movements

37

What may happen to vision in hyperth?

lid retraction
double vision
eyes that bulge out

38

What hair changes occur in hyperthyroidism?

brittle thinning hair

39

What happens to nail growth in hyperthyroid?

rapid

40

What happens to periods in hyperthyroidism?

lighter bleeding/less frequent

41

What happens to muscles in hyperth?

weakness, especially in thighs and upper arms

42

What happens to metabolism in hyper?

increased appetite but weight loss

43

What are nodular thyroid causes of hyperthyroid?

multi nodular goiter
toxic nodule (adenoma)

44

What are inflammatory types of hyperthyroid?

subacute
post-partum

45

What is seen on thyroid function tests in Grave's?

high T3/4, low TSH

46

What is Graves antibody positive for?

TRAbs

47

What is seen on ultrasound in graves?

smooth symmetrical goitre

48

In whom does nodular thyroid disease occur more?

older patients

49

Are nodular thyroid disease patients antibody TRAbs positive?

NO

50

What type of goiter is seen in in nodular thyroid disease?

assymetrical

51

What is De Quervains?

sub acute thyroiditis

52

What happens to T4 in sub acute thyroiditis?

high then low then normal

53

What happens to TSH in sub acute thyroiditis?

low then high then normal

54

What is Thyroid storm?

severe hyperthyroidism
resp and cardio collapse
hyperthermia
may be linked to infection

55

What is treatment of thyroid storm?

lugols iodine, glucocorticoids, PTU, B blockers, fluids, monitoring

56

Treatment of hyperthyroidism?

carbimazole
propylthiouracil (preferred in pregnancy)

57

What else should be used in hyperthyroid to treat symptoms?

propranolol

58

If a patient presents with tiredness/goiter and has a high TSH but a normal T4 what is the diagnosis?

subclinical hypothyroidism