Hypothyroidism

Question 1

what happens to T4 levels?

Answer 1

↓T4

Question 2

most common cause of hypothyroidism?

Answer 2

Hashimoto’s thyroiditis

Question 3

is hashimoto’s thyroiditis primary or secondary?

Answer 3

1° thyroid failure

Question 4

what type of disease is hashimoto’s thyroiditis?

Answer 4

autoimmune

Question 5

in hashimoto’s thyroiditis which leukocytes are involved?

Answer 5

T lymphocytes

Question 6

T lymphocytes attack what gland in hashimoto’s thyroiditis?

Answer 6

thyroid gland

Question 7

90% of people hashimoto’s thyroiditis have what antibodies?

Answer 7

anti-TPO antibodies

Question 8

what hypothyroidism is this:

fibrous tissue replaces normal thyroid tissues, get a pain less goitre?

Answer 8

Riedel thyroiditis

Question 9

which drugs can cause hypothyroidism?

-2

Answer 9

lithium and amiodarone

Question 10

Inborn errors of thyroid hormone synthesis are called what?

Answer 10

Congenital hypothyroidism

Question 11

which surgery/procurers can cause hypothyroidism?

-2

Answer 11

resected thyroid or irradiation

Question 12

which element do you need to make thyroid hormone?

Answer 12

Iodine

Question 13

most common cause of hypothyroidism in developing worlds

Answer 13

Iodine deficiency

Question 14

Hashimoto’s thyroiditis more common in females or males?

Answer 14

females

Question 15

which hypothyroidism can only occur in females?

Answer 15

Postpartum thyroiditis

Question 16

can hypothyroidism be idiopathic?

Answer 16

yes

Question 17

can you get goitre in Hashimoto’s thyroiditis?

Answer 17

yes

Question 18

will goitre in hashimoto’s thyroiditis be tender?

Answer 18

no

Question 19

character of goitre in hashimoto’s thyroiditis?

-2

Answer 19

firm, non tender

Question 20

hashimoto’s thyroiditis is assoc with what other autoimmune diseases?
-3

Answer 20

coeliac disease, T1DM, vitiligo

Question 21

hashimoto’s thyroiditis is how many x more common in females?

Answer 21

10x

Question 22

Define goitre?

Answer 22

swollen neck from enlarged thyroid gland

Question 23

what gutturia (latin) mean literally?

Answer 23

throat

Question 24

define diffuse goitre?

Answer 24

entire thyroid gland swollen

Question 25

define nodular goitre?

Answer 25

small lumps on thyroid gland

Question 26

how do diffuse goitre and nodular goitre differ when you feel them?

Answer 26

diffuse goitre - not lumpy | nodular goitre - lumpy

Question 27

define non-toxic goitre?

Answer 27

thyroid function is normal

Question 28

define toxic goitre?

Answer 28

thyroid function abnormal

Question 29

why is goitre made essentially in hypothyroidism?

Answer 29

compensate for low TH

Question 30

effect of iodine on the thyroid cells?

Answer 30

hyperplasia

Question 31

step by step how can I- Deficiency lead to goitre?

Answer 31

I- Deficiency > ↓T4 & T3 levels > ↑TSH to compensate > iodine influx into thyroid gland > thyroid cell hyperplasia > goitre made

Question 32

Congenital Hypothyroidism: how many neonates are affected?

Answer 32

1/4000 neonates

Question 33

why is congenital hypothyroidism an emergency?

Answer 33

If not treated within first 4 week you get irreversible cognitive impairment

Question 34

how to screen for congenital hypothyroidism?

Answer 34

heel prick test

Question 35

what happens to tone in congenital hypothyroidism?

Answer 35

hypotonia

Question 36

what happens to skin in congenital hypothyroidism?

Answer 36

jaundice

Question 37

what happens to tongue in congenital hypothyroidism?

Answer 37

macroglossia

Question 38

congenital hypothyroidism: what are the extra features? -6

Answer 38

jaundice short stature puffy face, macroglossia, hypotonia delayed physical and mental milestones

Question 39

is riedel’s thyroiditis | rare or common?

Answer 39

Very rare

Question 40

in riedel’s thyroiditis how will goitre feel? | -2

Answer 40

hard painless goitre

Question 41

how does thyroid gland change in riedel’s thyroiditis?

Answer 41

dense fibrous tissue replaces normal thyroid tissue

Question 42

in riedel’s thyroiditis as goitre grows what will eventually happen?

Answer 42

compression on nearby structures

Question 43

compressive symptoms from goitre? | -6

Answer 43

``` hoarseness dysphagia stridor dyspnoea choking cough ```

Question 44

Treatment for riedel’s thyroiditis? | -2 things

Answer 44

prednisolone + surgery to resect some thyroid

Question 45

Definition of Subclinical Hypothyroidism?

Answer 45

normal T4 but ↓TSH

Question 46

Cause of subclinical hypothyroidism?

Answer 46

multinodular goitres

Question 47

which gender is effected more by subclinical hypothyroidism?

Answer 47

females

Question 48

prognosis for subclinical hypothyroidism?

Answer 48

usually TSH goes back to normal spontaneously

Question 49

treatment for subclinical hypothyroidism if TSH still low after a while?

Answer 49

low-dose antithyroid agents for 6 months

Question 50

hypothyroidism: main gut symptom?

Answer 50

Constipation

Question 51

hypothyroidism: mood change? -1

Answer 51

Depressed

Question 52

hypothyroidism: weight changes?

Answer 52

weight gain

Question 53

hypothyroidism: symptom that effects women only?

Answer 53

Menorrhagia

Question 54

define Menorrhagia?

Answer 54

heavy periods

Question 55

symptoms of hypothyroidism? | -6

Answer 55

``` Constipation Cold Tired Depressed Weight gain No eyebrows ```

Question 56

hypothyroidism 1° to thyroid gland. what are the TFT results?

Answer 56

↓T4 ↑TSH

Question 57

hypothyroidism 2° to thyroid gland. what are the TFT results?

Answer 57

↓T4 ↓TSH

Question 58

pt has normal T4 and ↓TSH. what condition is this?

Answer 58

subclinical hypothyroidism

Question 59

pt has hypothyroidism. U+E changes? -2

Answer 59

↓Na+ ↑CK

Question 60

pt has hypothyroidism. LFT changes? -2

Answer 60

↑bilirubin, ALT

Question 61

pt has hypothyroidism. what happens to LDH?

Answer 61

↑

Question 62

what does LDH stand for?

Answer 62

Lactate dehydrogenase

Question 63

1st line IX to see goitres?

Answer 63

US

Question 64

mainstay drug for hypothyroidism?

Answer 64

levothyroxine

Question 65

Levothyroxine is an analogue of what hormone?

Answer 65

T4

Question 66

If hypothyroidism untreated it can lead to what emergency?

Answer 66

myxoedema Coma