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Endocrinology > Thyroid disorders > Flashcards

Thyroid disorders Flashcards

(50 cards)

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1
Q

Systems affected by thyroid disease

A
  • energy
  • weight
  • temp
  • heart
  • nervosu ssytem
  • GI system
  • MSK
  • SKIN
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2
Q

Energy

Hypo-

Hyper-

A

Hypo- low

Hyper- high

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3
Q
A
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4
Q

Weight

Hypo-

Hyper-

A

Weight

Hypo- increase

Hyper- loss

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5
Q

Temperature

Hypo-

Hyper-

A

Hypo- cold

Hyper- heat intolerant

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6
Q

Heart

Hypo-

Hyper-

A

Hypo- bradycardic

Hyper- tachycardic

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7
Q

Nervous system

Hypo-

Hyper-

A

Hypo- lethargic

Hyper- hypersensitive/ nervous irritability

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8
Q

GI system

Hypo -

Hyper-

A

Hypo - constipated

Hyper- more frequent bowels

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9
Q

MSK

Hyper-

A

shake on outstretched movement

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10
Q

Skin

Hypo-

A

itching

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11
Q

blood test results of primary hypothyroidsm

A

T4 low (2.4 pmol/L (8-25)

TSH high (150 miU/L (1-4.5)

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12
Q

blood test results of primary hyperthyroidsm

A

T4 high (86 pmol/L (8-25)

TSH low (<0.05miU/L (1-4.5)

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13
Q

thryoid exam

A

Can only feel if enlarged

Feeling for nodules and perfuse swellings

Ask patient to swallow

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14
Q

radioisotope scan

A

Give Technetium-99m via IV- a good uptaker of iodine (inject)

Can see gland activity

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15
Q

thyroid ultrascan

A

best way- structural scan

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16
Q

plain X-ray and CT scan

A
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17
Q

old fashioned word for hypothyroidism

A

myxoedema

Swelling of eyes and thickened skin

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18
Q

symptoms of hypothyroidism

A

Symptoms

Tiredness

Weight gain

Cold intolerance

Change in appearance

Depression

Psychosis

Joint/ muscle ache

Dry hair/ skin

Constipation

Puffy eyes

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19
Q

signs of hypothyroidism

A

Peri-orbital oedema- swelling of the eyes

Loss of lateral eyebrows

Dry, thin hair

Bradycardia

Slow-relaxing reflexes

Carpal tunnel syndrome

Cold peripheries

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20
Q

causes of hypothyroidism

A

Autoimmune atrophic

Hashimotos’ thyroiditis

Post-partum thyroiditis

Dyshormonogenesis (babies born with under active thyroid)

Medication

Iodine deficiency

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21
Q

children of iodine deficient mother

Study These Flashcards
A

all children have hypothyroidism

  • reduced IQ- cretinism
22
Q

Special situations in hypothyroidism

Study These Flashcards
A

Myxoedema coma

Borderline or sub-clinical hypothyroidism

23
Q

Myxoedema coma

Study These Flashcards
A

Severe hypothyroidism usually in the elderly.

Hypothermia and fluid overload in heart

50% mortality

24
Q

Borderline or sub-clinical hypothyroidism

Study These Flashcards
A

Low/normal T4 and high TSH

More common than severe hypothyroidism

Can be monitored until symptoms warrant treatment

25
treartment of hypothyroidism
Thyroxine replacement therapy
26
Thyroxine replacement therapy
Levothyroxine (T4) for life Starting dose depends on severity 100ug for young and fit person More caution in elderly and heart disease
27
aim of treatment with Thyroxine replacement therapy
Resolution of symptoms Normalisation of blood tests (6-8 weeks) High TSH suggests under replacement Low TSH suggests over replacement
28
symptoms of hyperthryoidism
Weight loss Irritability Restlessness Insomnia Malaise Itching Sweating Palpitation Tremor Muscle ache Diarrhoea
29
signs of hyperthyroidism
Tremor Hyperkinesis Tachycardia Atrial fibrillation (irreg irreg) Warm peripheries Hypertension Proximal myopathy Lid lag
30
lid lag and hyperthyroidism
31
Causes of hyperthryoidism
Graves disease Nodular thyroid disease Thyroiditis
32
graves disease
33
effects of graves
Graves ophthalmopathy Pretibial myxoedema (Graves dermopathy) Thyroid acropathy
34
Thyroiditis
Inflammation of thyroid Release of thyroxine into circulation
35
causes of thyroiditis
* Viral infection- de quervains thyroiditis * After birth- post partum * Medication- amiodarone
36
nodular hyperthryoidism- single toxic nodule
37
nodular hyperthryoidism- multi-nodular goitre
38
Special situations in hyperthyroidism
Thyroid crisis or thyroid storm Hyperthyroidism and pregnancy
39
Thyroid crisis or thyroid storm
Rare condition with 10% mortality Hyperpyrexia Tachycardia Cardiac failure Liver dysfunction Urgent treatment
40
Hyperthyroidism and pregnancy
* In graves disease antibodies can cross placenta * Baby can be born with hyperthyroidism * Requires close monitoring in pregnancy
41
treatment for hyperthryoidism
medication, surgery or radioactive iodine
42
medication for hyperthyroidism
* Carbimazole * Beware of agranulocytosis (reduces neutrophils) * Beta blocker for symptom control
43
Surgery for hyperthyroidism
* If side effects on medication or patient preference * Good cosmetic results * Small risk of laryngeal nerves palsy’s and hypocalcaemia
44
Radioactive iodine in treatment of hyperthyroidism
Good definitive non-surgical option Contra-indicated in pregnancy Radiation restriction guidance after treatment
45
most goitees caused by thyroid nodules are in
women (7%) men (1%)
46
Types of goitre
**Diffuse goitre** Simple goitre Auto-immune Thyroiditis **Nodular goitre** Multinodular goitre solitary nodule (red flag ) **Fibrotic goitre** Riedel’s thyroiditis – rare **Iodine deficiency** Common worldwide Rare in UK
47
Red flag symptoms of thyroid cancer: History
* Very young or old patient * Rapid enlargement of lump in neck * Hoarse voice and dysphagia * Family history of thyroid cancer
48
Red flag symptoms of thyroid cancer: examination
* Hard irregular thyroid mass * Fixed to surrounding structures * Cervical lymph nodes
49
Investigation of suspected thyroid cancer
Thyroid ultra sound Fine need aspiration CT scan thorax and mediastinum
50
if cytology suggests cancer
* Surgical removal * Prognosis is good

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