Thyroid Disease Flashcards
(21 cards)
hyperthyroidism age and gender prevalence?
F>M 5:1
20-40
hyperthyroidism TSH and T3/4 levels?
LOW TSH
HIGH T3/4
causes of hyperthyroidism
Graves' toxic multinodular goitre solitary toxic adenoma drug induced: levothyroxine, amiodarone hashitotoxicosis
what is Grave’s disease?
IgG autoAb stimulate thyroid follicular out of control
signs of Grave’s
opthalmopathy lagopthalmos exopthalmos opthalmoplegia peri-orbital oedema
what antibodies are found in Graves’?
TPO
TSH-R
signs and symptoms of hyperthyroidism
Sweating Weight loss Emotional lability Appetite increase Tremor Intolerance to heat Nervousness GI disturbances/goitre lid retraction opthalmopathy AF tachycardia pre-tibial myxoedema systolic HTN diarrhoea
how can you distinguish between Graves and toxic nodular goitre?
technetium uptake scan
diffuse: Graves
one or more hot nodules: toxic nodular goitre
reduced/absent uptake: thyroiditis
management of hyperthyroidism
surgery RAI (non Graves) 1. carbimazole 2. propylthiouracil (preferred substrate for TPO)
what are the SE of hyperthyroidism medication?
rashes
thrombocytopenia
agranulocytosis
carbimazole - obstructive jaundice
hyperthyroidism gender prevalence?
F>M, 10:1
hypothyroidism TSH and T3/4 levels?
HIGH TSH
LOW T3/4
hypothyroidism causes
autoimmune: Hashimoto’s
atrophic thyroiditis
drugs: amiodarone, iodine excess, lithium
iodine deficiency
which causes of hypothyroidism cause a goitre?
Hashimotos - symmetrical goitre
what is Hashimoto’s?
T cell destruction of gland and B cell secretion of inhibitory TSH-R Ab
hypothyroidism investigations
FBC: anaemia
TPO Ab: Hashimoto’s
cholesterol: increased in hepatic hypothyroidism
CK: increased in muscle hypothyroidism
hypothyroidism management
levo-thyroxine (L-T4)
hypothyroidism signs and symptoms
Memory loss Obesity Menorrhagia Skin and hair dry Onset slow Tiredness Intolerance to cold Raised BP Energy levels low Depression constipation hair loss anaemia goitre hoarse voice hyporeflexia
what is a goitre? how can it be described?
painless enlargement of thyroid gland
diffuse/nodular, simple/toxic, benign/malignant
differentials of a diffuse goitre
puberty pregnancy Graves Hashimotos de Quervains/Riedel's thyroiditis iodine def anti-thyroid drugs, lithium, amiodarone
differentials of a nodular goitre
MULTI: toxic multinodular goitre subacute thyroiditis SOLITARY: follicular adenoma benign nodule thyroid Ca lymphoma mets INFILTRATION TB, sarcoid
