L8 Thyroid Disease: Hyper, Hypo and Other Flashcards
What to look for when examining the thyroid
retrosternal extension- can cause tracheal deviation
- listen for bruit
- cervical lymph nodes
Name 2 thyroid autoantibodies
Anti-TPO AB - Thyroid peroxidase auto-antibody
TRAB - TSH receptor autoantibody
Best biomarker for thyroid status
TSH
Slow to respond to change
Assumes normal pituitary function
What do thyroid function tests show in someone who has primary hypothyroidism?
High TSH
Low T4 + T3
What do thyroid function tests show in someone who has secondary hypothyroidism?
Low TSH, T4, T3
Causes of thyrotoxicosis
- Autoimmune (Grave’s disease)
- Toxic multinodular goitre
- Toxic adenoma
- Thyroiditis
- Drugs (e.g. amiodarone)
Graves Disease
Autoimmune hyperthyroidism
Autoantibody stimulates the
TSH receptor, causing excess
thyroid hormone production
and thyroid growth (goitre)
Gestational thyrotoxicosis
Placental β-human chorionic gonadotrophin is structurally similar to TSH and TSH-like action on the thyroid
-likely if hyperemesis / twin pregnancy
Settles after 1st trimester of pregnancy
Graves disease
-diagnostic features
Personal or family history of any autoimmune thyroid / endocrine disease
Goitre with a bruit = Graves disease
Thyroid eye disease = Graves disease (20%)
Positive thyroid autoantibody titre
What autoantibody is commonly associated with autoimmune primary hypothyroidism i.e Hashimotos?
Anti-TPO
thyroid peroxidase usually causes iodide uptake into thyroglobulin
What autoantibody is commonly associated with autoimmune primary hyperthyroidism i.e. Graves?
TRAB
Symptoms of TED
Mild - itcy, dry eyes, prominent eyes,
Worrisome
-diplopia, loss of sight, loss of colour vision, redness, unable to close fully, ache/pain/tightness
