Hypothyrodism Flashcards
1
Q
What are causes of hypothyrodism?
A
PRIMARY
- Iatrogenic treatment of hyperthyroidism*
- Autoimmune HASHIMOTO’S THYROIDITIS
- Iodine deficiency
- Congenital defect
- Drugs (amiodarone, lithium, anithyroid meds)
- Infiltration of gland (amyloidosis, sarcoidosis, haematochromatosis)
SECONDARY
- Hypothalamic disorders (trauma, malignancy)
- Hypopituitarism
TRANSIENT
- Subacute (DE QUERVANS) thyroiditis
- Postpartum thyroiditis
- Withdrawal of suppressive therapy
2
Q
What are the symptoms of hypothyroidism?
A
Lethargy Weakness Cold sensitivity Constipation Weight gain Depression Menstrual irregularities Dry skin
3
Q
What are the signs of hypothyroidism?
A
Bradycardia Thick tongue Eye/Facial oedema Goitre Dry coarse skin Loss of lateral third of eyebrows
4
Q
What are the investigations for hypothyroidism?
A
BLOODS TSH = HIGH Free serum T4 = LOW FBC = anaemia (mild) Fasting blood glucose = HIGH Cholesterol = HIGH
5
Q
How is hypothyroidism managed?
A
Levothyroxine (1.6 microgram /kg/day)
6
Q
What else may investigations show in autoimmune Hashimoto’s Thyroiditis?
A
Anti-thyroid peroxidase
Anti Tg Antibodies
NB: maybe initial transient thyrotoxicosis in acute phase
7
Q
What is subclinical hypothyrodism?
A
- TSH raised but T3 and T4 normal
- No overt symptoms
Significance =
- Risk of progression to overt is 2-5% per year
- Higher in men and presence of thyroid antibodies
8
Q
When should subclinical hypothyroidism be treated?
A
TREAT IF: TSH >10 Thyroid antibodies present Other immune disorder Previous treatment of Graves
