Hypothyroidism/hyperthyroidism Flashcards Preview

Endocrinology > Hypothyroidism/hyperthyroidism > Flashcards

Flashcards in Hypothyroidism/hyperthyroidism Deck (20):
1

Chronic thyroiditis (Hashimotos thyroiditis)
Iodine deficiency
-goitrous or non-goitrous?

Goitrous
(primary hypothyroidism)

2

Hashimotos thyroiditis histology?

Presence of thyroid peroxidase antibodies (in blood)
T-cell infiltrate and inflammation of microscopy

3

Atrophic thyroiditis?

Non-goitrous
Primary hypothyroidism

4

Skin condition associated with hypothyroidism?

Vitiligo

5

What is the skin and face like in hypothyroidism?

Coarse, sparse hair
Dull expressionless face
Periorbital puffiness
Pale cool skin that feels doughy to touch
Vitiligo may be present
Hypercarotenaemia
Fluid Retention:
Pitting oedema

6

Cardiac signs of hypothyroidism?

Reduced heart rate
Cardiac dilatation
Pericardial effusion
Worsening of heart failure

7

Respiratory signs of hypothyroidism?

Deep hoarse voice
Macroglossia
Obstructive sleep apnoea

8

Tendon jerks in hypothyroidism?

Prolongation of tendon jerks

9

Neurology/CNS signs of hypothyroidism?

Carpal Tunnel Syndrome
(Cerebellar Ataxia, Encephalopathy)
Decreased Visual Acuity

Decreased intellectual and motor activities
Depression, psychosis, neuro-psychiatruc
Muscle stiffness, cramps
Peripheral Neuropathy
Prolongation of the tendon jerks

10

TRH effect on prolactin?

Hyperprolactinaemia - ↑ TRH causes ↑ prolactin secretion

Menorrhagia
Later oligo- or amenorrhoea

11

Thyroxine dose for younger patients?

Younger patients: start thyroxine at 50-100 μg daily

12

Thyroxine for older patients? (elderly)

In the elderly with a history of IHD: start thryroxine at 25-50 μg daily, adjusted every 4 weeks according to response

13

When should you check TSH after you have changed the dose?

Check TSH 2 months after any dose change
Once stabilised, TSH should be checked every 12-18 months

14

How do you monitor primary hypothyroidism treatment success?

Monitor using TSH levels

15

How do you monitor secondary hypothyroidism treatment success?

Monitor using T4 levels

16

Myxoedema coma findings?

ECG: bradycardia, low voltage complexes, varying degrees of heart block, T wave inversion, prolongation of the QT interval
Type 2 respiratory failure: hypoxia, hypercarbia, respiratory acidosis
Co-existing adrenal failure is present in 10% of patients
Hypothermia is usually present In myxedema crisis
Hypotension/shock
Standard hypothyroid signs
etc

17

Treatment for myxoedema coma?

Intensive care A, B, C
Passively rewarm: aim for a slow rise in body temperature
Cardiac monitoring for arrhythmias
Monitor blood pressure, CVP, oxygenation, urine output, blood glucose levels
Fluids/ fluid restrict/ electrolyte balance
Broad Spectrum Antibiotics
Thyroxine cautious (hydrocortisone

18

Amiodarone?

Amiodarone induced thyroid dysfunction!! Can cause hyper AND hypothyroidism

19

Amiodarone induced hypothyroidism and iodine uptake?

Common in areas with high iodine uptake

20

Goitre in Grave's disease?

Smooth symmetrical goitre