Thyroid Disease Flashcards
What is the most common form of hypothyroidism
Hashimoto’s disease
What is Hashimoto’s disease
An autoimmune disease resulting in either destruction of thyroid follicles or production of an antibody that blocks the TSH receptor on follicle cells
What is Grave’s disease
An autoimmune disease in which antibodies, thyroid stimulating immunoglobulins (TSIs) are produced that stimulate TSH receptors on follicle cells resulting in production of T3 and T4
What happens to TSH levels in Grave’s disease
TSH levels fall due to negative feedback from T3 and T4 acting on anterior pituitary gland
What drug can be given to treat Grave’s disease/hyperthyroidism
Carbimazole - converted to methimazole in the body where it inhbits thyroid peroxidase
Side effect is neutropenia
What are two signs which may be seen with Grave’s disease
Exophthalmos
Pre-tibial myxoedema
What are some signs and symptoms of hypothyroidism
Cold intolerance and reduced BMR
Weight gain
Tiredness and lethargy
Bradycardia
Neuromuscular system - weakness, muscle cramps, cerebellar ataxia
Dry and flaky skin
Alopecia - outer third of eyebrows especially
Deep and husky voice
Puffy eyes, face, hands, feet
Constipation
Memory problems, depression, psychosis
Menorrhagia
Pallor
Non-pitting oedema - myxoedema
What are some signs and symptoms of hyperthyroidism
Heat intolerance, increased oxygen comsumption and increased BMR
Weight loss in spite of increased appetite
Physical and metabolic hyperactivity
Tachycardia, atrial fibrillation, bounding pulse
Intestinal hyper-mobility
Skeletal and cardiac myopathy - tiredness, weakness, breathlessness
Osteoporosis due to increased bone turnover
Overactivity
Nervousness, anxiety, insomnia
Shacking, trembling
Increased sweating
Palpitations
Diarrhoea
Amenorrhea
Proximal muscle weakness/myopathy
Lid lag
Staring eyes
What are the causes of hypothyroidism
Failure of thyroid gland
TSH or TRH deficiency
Inadequate dietary supply of iodine
Radioactive iodine
Autoimmunity
Post surgery
Congenital
Anti-thyroid drugs
What is the treatment for hypothyroidism
Oral thyroid hormone - T4 as has longer half-life
What condition may arise due to remnants of the thyroglossal duct
Thyroglossal duct cyst
This is due to static fluid accumulation inside which becomes infected
How does a thyroglossal duct cyst present
As a swelling on the anterior of the neck, in the midline
Will move upwards when the tongue is protruded
What is goitre and what are the commonest causes
Enlargement of the thyroid gland, developing when thyroid gland is overstimulated
Can be diffuse, multinodular or single nodule
Commonest causes are: Iodine deficiency, multinodular goitre (colloid goitre)
What is retrosternal multinodular goitre
Where multinodular goitre enlarges inferiorly into superior mediastinum where to form retrostinal goitre which may cause tracheal compression
What may a child have if the pregnant mother is iodine deficient
Mental retardation
Abnormal gait
Deaf-mutism
Short stature
Goitre
Hypothyroidism
