Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Module 203 Reproduction & endocrinology > T1 L8 Thyroid disease: hyper, hypo and other > Flashcards

T1 L8 Thyroid disease: hyper, hypo and other Flashcards

1
Q

What is hypothyroidism?

A

Underproduction of thyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is hyperthyroidism?

A

Overproduction of thyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is thyrotoxicosis?

A

Overproduction of thyroid hormone (hyperthyroidism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is euthyroid?

A

Normal production of thyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a goitre?

A

Enlargement of the thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to examine the thyroid?

A 
Feel for thyroid cartilage then move down and lateral
Moves on swallowing
Listen for bruit 
Retrosternal extension 
Check cervical lymph node system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the normal ranges for a thyroid function test?

A

TSH: 0.3-4.2mu/l
FT4: 12-22pmol/l
FT3: 3.1-6.8pmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why doesn’t a negative autoantibody result exclude autoimmune disease?

A

May have different antibodies that aren’t tested for

Presence only helps to confirm a diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the different types of thyroid autoantibodies?

A

Destructive

Stimulatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a destructive thyroid autoantibody?

A

Target thyroid for autoimmune destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a stimulatory thyroid autoantibody?

A

Stimulates TSH receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the symptoms of hypothyroidism?

A 
Lethargy
Weight gain
Cold intolerance
Constipation
Facial puffiness
Dry skin
Hair loss
Hoarseness
Heavy menstrual periods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the signs of severe hypothyroidism?

A 
Change in appearance 
Periorbital oedema
Dry, flaking skin
Diffuse hair loss
Bradycardia
Signs of median nerve compression
Effusions
Delayed relaxation of reflexes
Croaky voice
Goitre
Stupor or coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the causes of primary hypothyroidism?

A 
Autoimmune hypothyroidism 
Hypothyroidism after treatment for hyperthyroidism
Thyroiditis
Drugs
Congenital hypothyroidism
Iodine deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the clinical results for primary hypothyroidism?

A

Increased TSH
Decreased T4
Decreased T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the causes of secondary hypothyroidism?

A

Diseases of hypothalamus or pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the clinical results for secondary hypothyroidism?

A

Decreased TSH
Decreased T4
Decreased T3

18
Q

Describe autoimmune hypothyroidism

A

Chronic autoimmune thyroiditis: Hashimoto’s

Myxoedema

19
Q

What is myxoedema?

A

Accumulation of glycosaminoglycans in interstitial spaces of tissue

20
Q

What are the symptoms of hyperthyroidism?

A 
Weight loss
Lack of energy
Heat intolerance
Anxiety / irritability
Increased sweating
Increased appetite
Thirst 
Palpitations
Pruritus
Weight gain
Loose bowels
Oligomenorrhoea
21
Q

What are the signs of hyperthyroidism?

A 
Tremor
Warm, moist skin
Sinus tachycardia
Atrial fibrillation
Brisk reflexes
Eye signs
Thyroid bruit
Muscle weakness
Atrial fibrillation
22
Q

What are the eye signs of hyperthyroidism?

A

Lid retraction
Proptosis
Ophthalmoplegia
Inflammation of conjunctiva

23
Q

What are the causes of hyperthyroidism?

A 
Autoimmune hyperthyroidism
Toxic multimodule goitre
Toxic adenoma
Thyroiditis
Drugs e.g. amiodarone
24
Q

Why does gestational thyrotoxicosis occur?

A

Placental HCG is structurally similar to TSH

More common if hyperemesis / twin pregnancy

25
Q

What is thyroid eye disease?

A

Inflammation of all orbital tissues except the eye

26
Q

What are some mild symptoms of thyroid eye disease?

A

Itchy / dry eyes

Prominent eyes / change in appearance / proptosis

27
Q

What are some more severe symptoms of thyroid eye disease?

A 
Diplopia / loss of sight
Loss of colour vision
Redness / swelling of conjunctiva
Unable to fully close eye
Ache / pain / tightness behind eye
28
Q

What is the active treatment for thyroid eye disease?

A

Encourage smoking cessation
Steroids
Immunosuppressive / steroid-sparing agents
Radiotherapy

29
Q

What are the surgical treatments for thyroid eye disease?

A

Orbital decompression

Eyelid surgery

30
Q

What is thyroid eye disease associated with in 20%?

A

Graves disease

31
Q

What increases the likelihood of Graves disease?

A

Personal or family history of autoimmune thyroid / endocrine disease
Goitre with a bruit
Thyroid eye disease
Positive thyroid autoantibody titre

32
Q

Describe the thyroid function test results in hyperthyroidism

A

Low TSH
Raised FT4
Raised FT3
TSH-receptor autoantibodies (Graves disease)

33
Q

What further investigations may be done in hyperthyroidism?

A

Thyroid autoantibodies

Thyroid uptake scan

34
Q

What is the medical treatment for Graves disease?

A 
Carbimazole or propylthiouracil
18 to 24 months
Titrate or block replace
1/3 have long term cure rate
2/3 will relapse
35
Q

What are the risks of surgical treatment for Graves disease?

A 
Anaesthetic
Neck scar
Hypothyroidism
Hypoparathyroidism
Vocal cord palsy due to recurrent laryngeal nerve damage
36
Q

What are the risks if no treatment is given for Graves disease?

A

Symptoms worsen
Atrial fibrillation - stroke
Osteoporosis - fractures

37
Q

What is a thyrotoxic crisis (thyroid storm)?

A

Associated with under or over treated hyperthyroidism

Heart rate, BP, temperature soar to extreme levels

38
Q

What increases the likelihood of a thyrotoxic crisis?

A 
Incompletely treated hyperthyroidism
Start-stop
Erratic compliance
Early on in course of treatment
Surgery / radioiodine treatment without adequate preparation
39
Q

What triggers a thyrotoxic crisis?

A

Surgery
Childbirth
Acute severe illness: infection, trauma, diabetic ketoacidosis, stroke, PE

40
Q

What is thyroiditis?

A

Self-limiting thyroid disease

Transient mild thyrotoxicosis
Resolves in 1-2 months
Give beta blockers if required

Longer hypothyroid phase
Last 4-6 months
May require thyroxine treatment for a while

41
Q

When should thyroiditis be considered?

A

If patient is pregnant or 1 year postpartum
Diabetes, family history of thyroid disease, smoker
Tender thyroid
Clinical thyroid status doesn’t fit with lab results
No diagnostic features of Graves disease
Current / recent treatment with immunomodulatory medication

42
Q

What other diseases are associated with thyroid disease?

A 
Type I diabetes
Pernicious anaemia
Coeliac disease
Premature ovarian failure
Addison's disease
Turner syndrome
Down's syndrome 
Medications: lithium, amiodarone

Module 203 Reproduction & endocrinology (52 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions