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Flashcards in Thyroid Disease Deck (73)
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1

If a thyroid condition is described as Primary, what is actually affected by the disease process?

affecting thyroid gland itself

2

Can thyroid disease occur both WITH and WITHOUT a goitre?

Yes
goitrous or non-goitrous

3

What type of disease process is usually responsible for types of thyroid disease?

Autoimmune

4

If there is a problem in the hypothalamus or pituitary gland, what is this referred to in terms of thyroid disease?

Secondary Thyroid disease

5

What is the other name for Thyroid Stimulating Hormone (TSH)?

thyrotropin

6

Where is TSH or Thyrotropin released from?

Thyrotroph cells in anterior pituitary

Released in response to Thyrotropin Releasing Hormone (TRH)

7

Describe the levels of Free T3/T4 and TSH found in Primary Hypothyroidism?

Free T3/4 low
TSH high (body's reaction to low circulating hormone)

8

Describe the levels of Free T3/T4 and TSH found in Primary Hyperthyroidism?

Free T3/4 high
TSH low

9

What is the difference in the level of TSH between primary and secondary Hypothyroidism?

TSH low (or ‘normal’) in secondary hypothyroidism

Due to problem being in pituitary/hypothalamus
=> less able to sense body's required response

10

What is the difference in the level of TSH between primary and secondary Hyperthyroidism?

TSH high (or 'normal') in secondary hyperthyroidism

11

What name is given to the condition which is a severe form of hypothyroidism causing a medical emergency?

Myxoedema

12

What disease does Pretibial Myxoedema usually indicate?

rare clinical sign of Graves’ disease

13

Incidence of thyroid disease is higher in White Caucasian populations than in ethnic minorities. TRUE/FALSE?

TRUE

higher in areas of high iodine intake

14

What conditions could cause Goitrous Primary Hypothyroidism?

- Chronic thyroiditis (Hashimoto’s)
- Iodine deficiency
- Drug-induced (e.g. amiodarone, lithium)
- Maternally transmitted (e.g. antithyroid drugs)

15

What conditions can cause Primary Hypothyroidism that presents without a goitre?

- Atrophic thyroiditis
- Post-ablative therapy (e.g. radioiodine, surgery)
- Post-radiotherapy (e.g. for lymphoma treatment)
- Congenital developmental defect

16

What forms of Primary Hypothyroidism can be self-limiting?

- Following withdrawal of antithyroid drugs
- Subacute thyroiditis with transient hypothyroidism
- Post-partum thyroiditis

17

What are the usual characteristics in Hashimoto's Thyroiditis?

- Antibodies against thyroid peroxidase (TPO)
- microscopic T-cell infiltrate and inflammation

18

What clinical signs of Hypothyroidism can occur in the skin?

- Coarse, sparse hair
- Periorbital puffiness
- Pale cool skin that feels doughy to touch
- Vitiligo
- Hypercarotenaemia (Yellowing Skin)

19

Patients experiencing hypothyroidism become intolerant to the heat. TRUE/FALSE?

FALSE
They become cold all the time
Patients with HYPERthyroidism become intolerant to the heat

20

What cardiac symptoms and complications can a patient with Hypothyroidism experience?

- Reduced heart rate
- Cardiac dilatation
- Pericardial effusion
- Worsening of heart failure
- Hyperlipidaemia

21

Patients with hypothyroidism find it easy to put on weight. TRUE/FALSE?

TRUE
can cause easy weight gain

22

Describe the GI symptoms experienced in both hypothyroidism and hyperthyroidism

HYPO = Constipation
HYPER = Diarrhoea

23

What respiratory symptoms can be experienced in hypothyroidism?

- Deep hoarse voice
- Macroglossia (unusally large tongue)
- Obstructive sleep apnoea

24

What neurological symptoms can arise from Hypothyroidism?

- Depression/psychosis/neuro-psychiatric
- Muscle stiffness, cramps
- Peripheral neuropathy
- Prolongation of the tendon jerks
- Carpal tunnel syndrome

25

Does Hypothyroidism cause heavier or lighter periods?

- Menorrhagia (heavier periods)
- Patients can also experience irregular periods or no periods at all

26

What is the starting dose for hypothyroid patients beginning on levothyroxine?

Younger patients = 50-100 μg daily

Elderly with Hx of IHD: start 25-50 μg daily, adjusted every 4 weeks according to response

27

How long after a dose change should a patient's TSH levels be checked?

2 months after any dose change

28

Once TSH is stabilised, how often should it be checked?

TSH should be checked every 12-18 months

29

Why is T3 therapy not often used in hypothyroidism?

T3 effects develop within a few hours and disappear within 24-48 hours of discontinuation

30

Dose requirements in hypothyroidism may increase in pregnancy. TRUE/FALSE?

TRUE
Due to increased TBG