hypothyroidism

Question 1

define hypothyroidism

Answer 1

Underproduction of thyroid hormones, T3 and T4 therefore Low levels of T3 (Triiodothyronine) and T4 (Thyroxine) in the body.

Question 2

what is primary hypothyroidism?

Answer 2

Abnormal thyroid function leading to decreased thyroid hormones.

Question 3

what is secondary hypothyroidism?

Answer 3

Abnormal hypothalamus or pituitary function leading to inadequateTSH which in turn leads to low T3 and T4.

Question 4

describe subclinical hypothyroidism

Answer 4

Mild symptoms may be seen in subclinical hypothyroidism, but levels of T3 and T4 are normal.

Question 5

what is the most common causes of hypothyroidism in the developed world?

Answer 5

is Hashimoto’s thyroiditis

Question 6

what is hashimotos thyroiditis?

Answer 6

Itis an autoimmune inflammation of the thyroid and can cause a goitre

Question 7

what is hashimotos thyroiditis associated with?

Answer 7

It is associated with anti-TPO antibodies and anti-thyroglobulin antibodies.

Question 8

what is the most common causes of hypothyroidism in the developing world?

Answer 8

Iodine deficiency as iodine is needed to make T3 and T4

Question 9

what can hypothyroidism lead to and what happens?

Answer 9

a Myxoedema coma/crisis due to an infection where T4 drops rapidly and causes reduced consciousness.

Question 10

name some additional causes of primary hypothyroidism

Answer 10

-DeQuervain’s thyroiditis
-Post-thyroidectomy or Post-Radioiodine
-Drugs: Amiodarone, lithium, carbimazole

Question 11

what is an important drug that can cause primary hypothyroidism or hyperthyroidism ?

Answer 11

AMIODARONE

Question 12

Name some secondary causes of hypothyroidism

Answer 12

-Sheehan’s syndrome
-Compression from pituitary tumour
-Drugs: Cocaine, steroids, dopamine (inhibit TSH secretion)

Question 13

what type of drug is amiodarone?

Answer 13

an anti- arrhythmic

Question 14

what are the signs of hypothyroidism?

Answer 14

-Hair loss
-Carpal Tunnel Syndrome
-Bradycardia
-Goitre
-Decreased deep tendon reflexes

Question 15

what are the symptoms for hypothyroidism?

Answer 15

-Weight Gain
-Cold Intolerance
-Lethargy
-Constipation
-Menorrhagia- heavy menstrual bleeding

Question 16

what is the epidemiology for hypothyroidism?

Answer 16

-Mainly under 40 years old
-More common in females (6:1)

Question 17

what is the treatment/ management for hypothyroidism?- what should you do with it?

Answer 17

Levothyroxine (T4) - Make sure to titrate the dose so you don’t cause hyperthyroidism.

Question 18

if a patient is suffering from a myxoedema crisis, what do you give them?

Answer 18

-Hydrocortisone
-Antibodies
-Levothyroxine

Question 19

how Is hypothyroidism diagnosed?

Answer 19

• Thyroid Function Tests- diagnosis and specific type
  -Anti- TPO antibodies- seen in both hyper and hypo but more common in hypo
• Thyroid ultrasound

Question 20

In a Thyroid Function test what would primary hypothyroidism look like- TSH levels and T3 + T4?

Answer 20

TSH- High
T3+T4- Low

Question 21

In a Thyroid Function test what would secondary hypothyroidism look like- TSH levels and T3 + T4?

Answer 21

TSH- low
T3+T4- Low

Question 22

In a Thyroid Function test what would subclinical hypothyroidism look like- TSH levels and T3 + T4?

Answer 22

TSH- high
T3 + T4- normal