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GP Conditions Year 4 > Thyroid (hypo and hyper) > Flashcards

Thyroid (hypo and hyper) Flashcards

1
Q

hyperthyroidism TSH

A

low

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2
Q

hypothyroidism TSH

A

high

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3
Q

anti-TPO antibodies

A

graves disease and hashimotos thyroiditis

antibodies against thyroid gland

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4
Q

anti-thyroglobulin antibodies

A

antibodies against a protein produced and present in thyroid gland

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5
Q

TSH receptor antibodies

A

autoantibodies which cause graves disease

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6
Q

USS

A

thyroid nodules
cystic vs solid nodules
guide biopsy of thyroid lesion

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7
Q

radioisotope scan

A

hyperthyroidism and thyroid cancers
radioactive iodine IV
gamma camera

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8
Q

thyrotoxicosis

A

abnormal and excessive quantity or thyroid hormone in the body

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9
Q

primary hyperthyroidism

A

thyroid pathology

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10
Q

secondary hyperthyroidism

A

overstimulation by TSH

hypothalamus or pituitary

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11
Q

graves disease

A

autoimmune
TSH receptor antibodies
most common cause of hyperthyroidism

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12
Q

toxic multinodular goitre

A

nodules on thyroid act independently and produce excess thyroid hormone

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13
Q

exopthalmos

A

bulging of eyeball out of the socket caused by graves disease
inflamamtion, swelling and hypertrophy

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14
Q

pretibial myxoedema

A

mucin deposits under skin on anterior leg

discoloured, waxy, oedematous appearance

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15
Q

pretibial myxoedema is specific to what?

A

graves disease

reaction to TSH receptor antibodies

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16
Q

features of hyperthyroidism

A 
anxiety and irritability
sweating and heat intolerance
tachycardia 
weight loss 
fatigue 
frequent loose stools
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17
Q

unique features of graves disease

A

diffuse goitre
graves eye disease
bilateral exopthalmos
pretibial myxoedema

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18
Q

unique features of multinodular goitre

A

goitre with firm nodules

age over 50

19
Q

solitary toxic thyroid nodule

A

usually benign adenomas

surgical removal

20
Q

De Quervains thyroiditis

A

viral infection with fever, neck pain and tenderness
dysphagia and hyperthyroidism features
then hypothyroidism

21
Q

treating de quervains thyroiditis

A

NSAIDs and beta blockers

22
Q

thyroid storm presentation

A

pyrexia
tachycardia
delirium

23
Q

treating thyroid storm

A

fluids, anti-arrhythmics and beta blockers

24
Q

Treating hyperthyroidism

A 
carbimazole 
propylthiouracil
radioactive iodine 
beta blockers 
surgery
25
Q

2 treatment regimes of carbimazole

A

titration block

block and replace

26
Q

propylthiouracil risks

A

hepatic reactions

27
Q

how is radioactive iodine treatment used?

A

drink single dose of radioactive iodine

patients can be left hypothyroidism and require levothyroxine

28
Q

strict rules radioactive iodine

A

not pregnant

avoid close contact with children for 3 weeks

29
Q

beta blocker of choice

A

propanolol

blocks adrenergic activity

30
Q

surgery - hyperthyroidism

A

whole thyroid or toxic nodules

hypothyroid post thyroidectomy

31
Q

Most common cause of hypothyroidism in developed world

A

hashimotos thyroiditis

32
Q

cause of hashimotos thyroiditis

A

autoimmune inflammation of thyroid gland

33
Q

hashimotos thyroiditis antibodies

A

antithyroid peroxidase (anti-TPO) and antithyroglobulin antibodies

34
Q

change in thyroid gland hashimotos thyroiditis

A

initial goitre then atrophy

35
Q

most common cause worldwide of hypothyroidism

A

iodine deficiency

36
Q

other causes of hypothyroidism

A

anti-thyroid medications eg carbimazole, thyroid surgery
lithium
pituitary gland

37
Q

lithium and thyroid

A

inhibits production of thyroid hormones

goitre and hypothyroidism

38
Q

amiodarone and thyroid

A

interferes with thyroid hormone production and metabolism

can cause hypothyroidism and thyrotoxicosis

39
Q

secondary hypothyroidism

A

pituitary gland fails to produce enough TSH

hypopituitarism

40
Q

causes of secondary hypothyroidism

A

tumours
infection
vascular - sheehan
radiation

41
Q

presentation of hypothyroidism

A 
weight gain 
fatigue 
dry skin 
coarse hair and hair loss
fluid retention 
heavy or irregular periods
constipation
42
Q

differentiating primary and secondary hypothyroidism

A 
primary = high tsh and low t3 and t4 
secondary = low tsh and low t3 and t4
43
Q

management of hypothyroidism

A

oral levothyroxine (synthetic t4 metabolised to t3)

44
Q

changing dose of levothyroxine

A

if TSH is high the dose is too low and vice versa

check bloods monthly until TSH stable

GP Conditions Year 4 (72 decks)

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