Session 11 - Thyroid disorders Flashcards
(26 cards)
Name the biochemical assessments used for the examination of the thyroid gland
- T3
- T4
- TSH levels
What are the clinical assessments used for the examination of the thyroid gland?
- Feel if it’s enlarged
- nodules swelling
- ask the patient to swallow and see if it moves
- examine patients heart rate, temperature and skin
What are the imaging assessments used for the examination of the thyroid gland?
- X-ray (Structure- compression of the trachea)
- CT scan (Structure)
- Thyroid Scintigraphy ( Technetium- function)
- Ultrasound (Structure)
What is hypothyroidism?
- Low levels of T3 and T4
- Elevated TSH
Hypothyroidism
What are some of the symptoms of this?
- Tiredness
- Weight gain
- Puffy eyes
- Constipation
- Joint/muscle ache
- Change in appearance
- Depression
Hypothyroidism ‘
What are some of the signs for this?
- Peri-orbital oedema (swollen eyes)
- ‘Peaches and cream’ (myxoedema- swelling of eyes and skin)
- Dry, thin hair (alopecia)
- Bradycardia
- Cold peripheries
- slow reflexes
Hypothyroidism
What are the causes of this?
- Autoimmune (Hashimotos- the destruction of thyroid follicles)
- Failure of the thyroid gland
- TSH or TRH deficiency
- Inadequate dietary supply of iodine
- Post-surgery
- Congenital
- Anti-thyroid drugs
Hypothyroidism
What is cretinism?
- the complication that occurs in infants
- mother had an inadequate dietary supply of iodine
- therefore baby born with iodine deficiency
Hypothyroidism
What are the features of cretinism?
- dwarfed structure
- mental deficiency ( thyroid hormone needed for the myelination of nerves and development of neurons)
- poor bone development
- muscle weakness
- slow pulse
Hypothyroidism
What is myxoedema?
Swelling of the eyes and skin
Hypothyroidism
What are the features of myxoedema?
- thick puffy skin
- muscle weakness
- slow speech
- mental deterioration
- intolerance to cold
Hypothyroidism
What are the treatments for this?
- T4 thyroxine replacement therapy
- oral thyroid hormone
- 50-200 microgram/day in a single dose
Hypothyroidism
What is myxoedema coma?
- rare
- very low temp (hypothermia) and pulse
- pericardial effusion
- 50% mortality rate
- severe hypothyroidism
- usually in the elderly
Hypothyroidism
What is borderline or subclinical hypothyroidism?
- low normal T3, T4 and high TSH ( caught it early or just normal)
- monitored until symptoms warrant treatment
What is hyperthyroidism?
- High T3, T4
- reduced TSH levels
Hyperthyroidism
What are the symptoms of this?
- Weight loss
- Malaise
- Palpitations
- Tremor
- Muscle ache
- Diarrhoea
- Insomnia
- Itching
Hyperthyroidism
What are the signs for this?
- Tremor
- Hyperkinesis
- Tachycardia
- Atrial fibrillation
- Hypertension
- Warm peripheries
- Lid lag (bulging eyes)
Hyperthyroidism
What are the causes of this?
- Autoimmune (Graves’ disease - thyroid-stimulating immunoglobulin)
- Ectopic thyroid tissue
- Excessive T3 or T4 therapy
- Drugs (amiodarone)- thyroiditis
- toxic multinodular goitre
Hyperthyroidism
What is the name of the medication given to treat this?
- Carbimazole or Propylthiouracil ( blocks formation of thyroid hormone)
- beware of agranulocytosis (risk of infections)
- beta-blockers for symptoms control
Hyperthyroidism
What is the surgical treatment for this?
- given if there are side effects from drugs or patients wants it
- small risk of laryngeal nerve palsy and hypocalcaemia
Hyperthyroidism
What are the features of a thyroid crisis or thyroid storm?
- rare
- 10% mortality
- hyperpyrexia
- tachycardia
- cardiac failure
- needs urgent treatment
Hyperthyroidism
What is the link between hyperthyroidism and pregnancy?
- in Graves’ , antibodies can cross the placenta
- infants born with hyperthyroidism
- pregnancy monitored closely
What are the 4 types of goitre?
- Diffuse goitre ( autoimmune, thyroiditis)
- Nodular goitre ( multinodular goitre, solitary nodule)
- fibrotic goitre
- iodine deficiency goitre
What is the history of a person who may have thyroid cancer( nodular goitre)?
- a very young or old patient
- rapid enlargement of a lump in the neck
- hoarse voice and dysphagia (difficulty swallowing)
- family history of thyroid cancer
