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2a Endocrinology > Hypothyroidism > Flashcards

Hypothyroidism Flashcards

1
Q

Hypothyroidism can be c____ or acquired

A

congenital

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2
Q

Thyroid hormone is essential for d____ and f______ of the b____ and b___

A

development and functioning of the brain and body

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3
Q

Undiagnosed hypothyroidism can cause problems with n_____ and i_____ d_____ in children

A

neurodevelopment and intellectual disability

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4
Q

True of false: congenital hypothyroidism is screened for?

A

True
During newborn blood spot screening test

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5
Q

What is the most common cause of acquired hypothyroidism?

A

Autoimmune thyroiditis (AKA Hashimoto’s thyroiditis)

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6
Q

Which antibodies is Hashimoto’s thyroiditis associated with?

A

Anti-Thyroid Peroxidase (anti-TPO) antibodies and Antithyroglobulin Antibodies

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7
Q

Hashimoto’s thyroiditis is associated with other autoimmune conditions, particularly…

A

T1DM and Coeliac disease

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8
Q

What are symptoms of hypothyroidism?

A

Fatigue and low energy
Weight gain
Poor growth
Poor school performance
Constipation
Dry skin
Hair loss
Cold intolerance
Menorrhagia (heavy periods)

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9
Q

What are some signs of hypothyroidism

A

Bradycardia
Slow reflexes
Cold hands
Goitre (in Hashimoto’s and iodine deficiency)
Pretibial myxoedema

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10
Q

What investigations are there for hypothyroidism?

A

Full thyroid function blood tests (TSH, T3 and T4)
Thyroid ultrasound
Thyroid antibodies

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11
Q

How do you manage hypothyroidism?

A

Levothyroxine, once daily

Dose titrated depending on thyroid function tests and symptoms.

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12
Q

Who is most at risk of hypothyroidism?

A

Women, ageing and postpartum

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13
Q

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

A

Hashimoto’s thyroiditis (autoimmune)

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14
Q

What are the most common causes of hypothyroidism in the developing world?

A

Iodine deficiency and postpartum thyroiditis

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15
Q

What is the mechanism of postpartum thyroiditis?

A

Same as Hashimoto’s thyroiditis, autoimmune. Present during pregnancy. However, resolves itself within 1 year of symptoms..

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16
Q

How does amiodarone (anti-arrhythmia medication) affect thyroid function?

A

Amiodarone has high iodine content and can prevent conversion of T4 to T3 (more active state). Leads to hypothyroidism despite high/normal levels of T4.
Can also cause inflammation of thyroid gland itself, initially causing release of thyroid hormone (hyperthyroidism) but then progresses to hypothyroidism due to damaged tissue.

17
Q

What is De Quervain’s thyroiditis?

A

Inflammation of thyroid gland, perhaps due to coxsackie virus.

Initial stage, release store thyroid hormones causing hyperthyroidism.

As inflammation resolves, thyroid’s ability to produce hormones impaired leading to transient hypothyroidism.

Thyroid function normally returns as gland recovers.

18
Q

Secondary _____ can also cause hypothyroidism

A

hypopituitarism

Hypothalamus fails to produce enough TRH to stimulate the pituitary gland to produce TSH.

19
Q

What are the TSH and T4 levels in primary hypothyroidism (Hashimoto’s thyroiditis)?

A

High TSH
Low T4

20
Q

What are the TSH and T4 levels in secondary hypothyroidism?

A

Low TSH
Low T4

21
Q

What are the TSH and T4 levels in subclinical hypothyroidism?

A

High TSH
Normal T4

22
Q

Those with hypothyroidism will commonly also have _____

A

anaemia

23
Q

Why is anaemia associated with hypothyroidism?

A

Hypothyroidism slows down overall metabolic activity in the body which includes bone marrow’s production of erythropoietin so fewer RBCs produced.

Also can cause changes to iron absorption.

Can also cause menorrhagia so more blood loss.

24
Q

What is a complication of hypothryoidism?

A

Myxoedema coma

25
Q

What is myxoedema?

A

Severe hypothyroidism, deficiency in T3 and T4.
Build of glycosaminoglycans in tissues and skin, causing swelling and non-pitting oedema.

26
Q

What often precipitates myxoedema coma?

A

An infection

27
Q

What are symptoms of myxoedema?

A

Generalised swelling
Hypothermia
Mental sluggishness
Loss of consciousness
Heart failure (bradycardia, increased systemic vascular resistance, decreased stroke volume)

28
Q

How does thyroid hormone impact the heart normally?

A

T3 and T4 increase the heart rate, increase cardiac output, help regulate blood pressure and influence the responsiveness of blood vessels to stimuli.

29
Q

How do you treat myxoedema coma?

A

levothyroxine
Antibiotics to treat the infection
Give hydrocortisone until adrenal insufficiency has been ruled out.

2a Endocrinology (26 decks)

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