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LCRS - Endo and Neuro > Lecture 7 - Thyroid Disorders > Flashcards

Lecture 7 - Thyroid Disorders Flashcards

1
Q

Draw a diagram of the thyroid

A

2 major lobes, L and R (largest) 4 parathyroid glands Isthmus in centre Pyramidal lobe in triangle

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2
Q

What is the origin of the thyroid?

A

Back of the tongue

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3
Q

Where is the foramen caecum?

A

Dimple at back of tongue (disappearing thyroglossal duct)

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4
Q

What is the adult thyroid weight?

A

20g

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5
Q

How many lobes are there?

A

4 lobes

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6
Q

Where can you find aberrant parathyroid glands?

A

Can be higher up on neck

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7
Q

What is the foramen caecum?

A

The entry to the persistent thyroglossal duct

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8
Q

How is the thyroid formed embryologically?

A

Midline outpouching of floor of pharynx This forms duct which elongates down (thyroglossal duct) Migrates down neck and divides into 2 lobes

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9
Q

When does thymus move into final position?

A

By week 7

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10
Q

What happens to the thyroglossal duct?

A

It disappears leaving the foramen caecum, where the thyroid gland then develops

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11
Q

What are the dimensions of each lobe?

A

4*2.5*2.5cm

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12
Q

Which nerve runs close to the thyroid?

A

Left recurrent laryngeal nerve

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13
Q

Why is it difficult to operate on the thyroid?

A

Damage to the nerve can cause changes in quality of voice/difficulty talking

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14
Q

What are the main problems with development?

A

Agenesis Incomplete descent Thyroglossal cyst

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15
Q

What is agenesis?

A

Complete absence of gland Not very good prognosis as no thyroxine released

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16
Q

What is a thyroglossal cyst?

A

Segment of thyroglossal duct persists and presents as lump years later

17
Q

What is the prognosis of a lingual thyroid?

A

Can be lethal if not treated with thyroxine

18
Q

What is a lingual thyroid?

A

An ectopic thyroid present at the top of the throat, which hasn’t descended at all - surgery as treatment option

19
Q

Why is thyroxine essential for brain development?

A

Neonates with T4 deficiency in utero have irreversible brain damage - CRETIN

20
Q

What is a cretin?

A

Individual with irreversible brain damage caused by lack of thyroxine Has thicker tissues Stunted growth

21
Q

How do you diagnose and treat cretinism?

A

Heel prick test at 5-10 days (mother’s T4 can falsify test) - measures TSH or Phenylketonuria (Guthrie test) Thyroxine given immediately after - if TSH too high

22
Q

Where is thyroxine synthesised?

A

Thyroid follicular cell

23
Q

What does the colloid contain?

A

Thyroglobulin and stored thyroxine

24
Q

What is the difference between thyroglobulin and thyroxine binding globulin?

A

TBG bonds 75% of T4 in circulation VS Thyroglobulin is inside thyroid gland only

25
Q

Thyroid diseases affect which sex more?

A

Females in a 4:1 ratio - women more susceptible to auto-immune diseases

26
Q

What are the thyroid’s common functions?

A

Synthesis, storage and secretion of thyroid hormones -> regulate growth, development and metabolic rate

27
Q

Thyroid disease affects how much of the population?

A

5% - 1:1 ratio of over and underactive thyroids

28
Q

What are the type of thyroidisms?

A

Primary hypOthyroidism (myxoedema) Overactive thyroid gland (hypothyroidism) Graves’ Disease

29
Q

What is Myxoedema - symptom of primary hypothyroidism?

A

1ry thyroid failure

Autoimmune/operation damage to thyroid

Thyroxine levels DECREASE > TSH levels INCREASE

30
Q

What are some features of primary hypothyroidism?

A

Deepening voice

Depression and tiredness

Cold intolerance

Weight gain with reduced appetite

Constipation

Bradycardia

Eventual myxoedema coma

31
Q

What are some methods of treatment of primary hypothyroidism?

A

Essential - death otherwise: Cholesterol ^ causing death from heart attacks/stroke Replace thyroxine - monitor levels, ensuring TSH returns to normal

32
Q

What is an overactive thyroid gland?

A

TOO MUCH thyroxine TSH levels FALL to ZERO a.k.a. HYPERTHYROIDISM/THYROTOXICOSIS

33
Q

What are the symptoms of an overactive thyroid gland?

A

^ basal metabolic rate

^ temperature - hot

^ appetite, lose weight

Tachycardia

Myopathy

Mood swings

Diarrhoea

Tremor of hands

Palpitations

Sore eyes, goitre

34
Q

What are the causes of an overactive thyroid gland?

A

GRAVES’ DISEASE

Toxic multinodular goitre

Thyroiditis

35
Q

What is Graves’ disease?

A

Whole gland is smoothly enlarged and overactive

Autoimmune disease - Ab bind and stimulate TSH receptor

Causes Goitre and HERT

36
Q

What are the symptoms of Graves’ disease?

A

Proptosis, Periorbital oedema, PRETIBIAL MYXOEDEMA, Exopthalmos, Clubbing, Amenorrhea, Tremor

37
Q

What is pretibial myxoedema?

A

Swelling occurring on shins of Graves’ patients - growth of soft tissue

38
Q

What are the thyroid levels signs of OTG?

A

^ T3 and 4 LESS TSH

39
Q

What are the thyroid level signs of OTG?

A

LESS T3 and 4 ^ TSH

LCRS - Endo and Neuro (22 decks)

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