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Flashcards in Thyroid disease Deck (34):
1

symptoms of thyrotoxicosis

diarrhoea, weight loss, appetite increase,sweats, heat intolerance, palps, tremor, irritable. rare- pyschosis, chorea

2

signs of thyrotoxicosis

pulse fast/irregular, warm moist skin, fine tremor, palmar erythema, lid lag, lid retraction, goitre, thyroid nodules, bruits

3

what is Graves disease, typical age and male to female ratio

hyperthyroidism, 40-60 years, 9:1 female:male

4

signs of Graves disease

exophthalmos, opthalmoplegia, pretibial myxoedema, clubbing, painful finger and toe swelling, periosteal reaction in limb bones

5

tests for thyrotoxicosis

TSH down, T4 and T3 up. mild normocytic anaemia, mild neutropenia, ESR up, Ca up, LFT up

6

cause of Graves

circulating IgG autoantibodies bind to and activate GPCR thyrotropin receptors- smooth thyroid enlargement and increased hormone production

7

triggers of Graves

stress, infection, childbirth

8

what are the causes of thyrotoxicosis

Graves, toxic multinodular goitre, toxic adenoma, ectopic thyroid tissue, exogenous (iodine excess, levothyroxine excess).

9

what are the diffuse causes of goitre

physiological, Graves, Hashimotos thyroiditis, subacute (de Quervain's) thyroiditis

10

what are the nodular causes of goitre

multinodular goitre, adenoma, carcinoma

11

how can you treat thyrotoxicosis

drugs- b blockers, carbimazole; radioiodine (CI- pregnancy, lactation); thyroidectomy

12

complications of thyrotoxicosis

heart failure (thyrotoxic cardiomyopathy), angina, AF, osteoporosis

13

how many Graves patients present with thyroid eye disease and what is the main known risk factor

25-50%. smoking

14

what is the medical emergency associated with hyperthyroidism

thyroid storm

15

what are the manifestations of Graves- heart

incr rate, incr contractility

16

what are the manifestations of Graves- liver

incr peripheral T3, decr LDL

17

what are the manifestations of Graves- bone

incr bone turnover, osteoporosis

18

what are the manifestations of Graves- genital

male- decr libido and erectile dysfunction, female- irregular menses

19

what are the manifestations of Graves- metabolic, fat

thermogenesis, incr O2 use; decr fat mass

20

what are the manifestations of Graves- CNS

stiff person syndrome

21

what are the manifestations of Graves- muscle

proximal myopathy

22

what are the manifestations of Graves- thyroid

incr secretion T3 and T4

23

more common age and gender of hypothyroidism

>40 years, female 6:1

24

symptoms of hypothyroidism

tired, sleepy, lethargic, mood decr, cold disliking, weight incr, constipation, hoarse voice, decr memory, dementia, myalgia, weakness

25

signs of hypothyroidism

BRADYCARDIC- Reflexes relax slowly, Ataxia, Dry thin hair/ skin, Yawning/drowsy/coma, Cold hands, Ascites +/- non pitting oedema, Round puffy face, Defeated demeanour, Immobile, CCF. neuropathy, myopathy, goitre

26

diagnosis of hypothyroidism

TSH incr T4 decr

27

causes of primary autoimmune hypothyroidism

primary atrophic hypothyroidism; Hashimotos thyroiditis

28

what is Hashimotos thyroiditis

goitre due to lymphocytic and plasma cell infiltration

29

what is the main cause of hypothyroidism worldwide

iodine deficiency

30

what are the causes of primary hypothyroidism

iodine deficiency, post thyroidectomy or radioiodine treatment, drug induced, subacute thyroiditis

31

what occurs in secondary hypothyroidism

not enough TSH, rare, hypopituitarism

32

what are the pregnancy problems associated with hypothyroidism

eclampsia, anaemia, prematurity, decr birthweight, stillbirth, PPH

33

what are the associated conditions with hypothyroidism

Turners, Downs, CF, primary biliary cirrhosis

34

what is the treatment for hypothyroidism

levothyroxine (T4).