Thyroid Disease Flashcards
If a thyroid condition is described as Primary, what is actually affected by the disease process?
affecting thyroid gland itself
Can thyroid disease occur both WITH and WITHOUT a goitre?
Yes
goitrous or non-goitrous
What type of disease process is usually responsible for types of thyroid disease?
Autoimmune
If there is a problem in the hypothalamus or pituitary gland, what is this referred to in terms of thyroid disease?
Secondary Thyroid disease
What is the other name for Thyroid Stimulating Hormone (TSH)?
thyrotropin
Where is TSH or Thyrotropin released from?
Thyrotroph cells in anterior pituitary
Released in response to Thyrotropin Releasing Hormone (TRH)
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)
Describe the levels of Free T3/T4 and TSH found in Primary Hyperthyroidism?
Free T3/4 high
TSH low
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
What is the difference in the level of TSH between primary and secondary Hyperthyroidism?
TSH high (or ‘normal’) in secondary hyperthyroidism
What name is given to the condition which is a severe form of hypothyroidism causing a medical emergency?
Myxoedema
What disease does Pretibial Myxoedema usually indicate?
rare clinical sign of Graves’ disease
Incidence of thyroid disease is higher in White Caucasian populations than in ethnic minorities. TRUE/FALSE?
TRUE
higher in areas of high iodine intake
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)
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
What forms of Primary Hypothyroidism can be self-limiting?
- Following withdrawal of antithyroid drugs
- Subacute thyroiditis with transient hypothyroidism
- Post-partum thyroiditis
What are the usual characteristics in Hashimoto’s Thyroiditis?
- Antibodies against thyroid peroxidase (TPO)
- microscopic T-cell infiltrate and inflammation
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)
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
What cardiac symptoms and complications can a patient with Hypothyroidism experience?
- Reduced heart rate
- Cardiac dilatation
- Pericardial effusion
- Worsening of heart failure
- Hyperlipidaemia
Patients with hypothyroidism find it easy to put on weight. TRUE/FALSE?
TRUE
can cause easy weight gain
Describe the GI symptoms experienced in both hypothyroidism and hyperthyroidism
HYPO = Constipation HYPER = Diarrhoea
What respiratory symptoms can be experienced in hypothyroidism?
- Deep hoarse voice
- Macroglossia (unusally large tongue)
- Obstructive sleep apnoea
What neurological symptoms can arise from Hypothyroidism?
- Depression/psychosis/neuro-psychiatric
- Muscle stiffness, cramps
- Peripheral neuropathy
- Prolongation of the tendon jerks
- Carpal tunnel syndrome