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53 Cards in this Set
- Front
- Back
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Mechanism of action of TSH? |
Activate cAMP |
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Amount of Plasma Bound Iodine? |
3.5-8.0 micrograms/100ml |
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Level of Physiologically Active Thyroxine |
0.004 micrograms/100 ml unbound thyroxine |
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Anti thyroid drugs? |
Neomarcazole, Thiourea, Thiocyanate, Perchlorate |
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Goitre |
Beingn Enlargement of the thyroid Gland |
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Types of Goitre |
Simple, Toxic, Neoplastic, Thyroiditis |
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Simple Goitre |
Diffuse Hyperplastic, Colloid, Nodular |
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Toxic Goitre |
Diffuse Toxic(Grave's) , Toxic Nodular |
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Types of Thyroiditis |
Autoimmune, Quervain's, Reidal's |
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Jodbasedow's Disease |
Excess ingestion of Iodine developed goitre with thyrotoxicosis |
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RDA of Iodine |
0.1-0.15 mg |
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Enzyme that converts Iodine to Iodide? |
Thyroid Peroxidase (TPO) |
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Name the Goitrogens |
Brassica Family : Cabbage, turnip, cauliflower, brussel Less Iodine.. More Calcium |
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Three Stages of Goitre |
1.Stage of Diffuse Hyperplasia 2.Stage of Involution 3.Stage of Colloid Goitre |
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How are nodules formed in the thyroid? |
Fluctuating Levels of TSH cause active and inactive portion of follicles.. Giving nodular appearance |
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Pendred's Syndrome |
Deafness + Goitre |
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Goitre too big having pressure effect on trachea and oesophagus? |
Dysphagia |
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Involvement of the RLN? |
Horner's Syndrome |
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Identify Thyroid Swelling? |
Swelling moves up on swallowing |
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Nature of the Nodules |
Cystic, Hemorrhagic, Degenerative, Calcification |
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When does the swelling move down? |
1.Invasive nature as in Carcinoma 2.Intrathoracic Extension 3.Thyroiditis |
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Consistency of Swelling in Simple Goitre |
Soft |
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Special Investigation of Simple Goitre |
1.Thyroid Function Tests 2.Straight X-ray of neck and chest 3. Barium Swallow X-ray for dysphagic cases 4. Needle Biopsy |
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Indications for operation of Thyroid |
1. Cosmetic Reasons 2. Pressure Symptom, Pain 3. Intra glandular Hemorrhage causing respiratory obstruction |
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Operation done for Non-nodular goitre??? |
Partial Thyroidectomy |
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Is there thyroxine supplementation after thyroidectomy?? |
Yes for Simple Goitre No for Thyrotoxicosis cases(Subtotal Thyroidectomy) |
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How do you treat Multinodular Goitre? |
Thyroid Extract of 120-180 mg/day |
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If nodularity persists in Multinodular Goitre.. What to do? |
Partial Thyroidectomy. Post-op 0.1 mg of L-Thyroxin to suppress TSH indefinitely |
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Why Retrosternal Goitre occurs in short men?? |
Short Neck, Strong Pretracheal Muscles, Negative Intrathoracic Pressure pulls the Goitre into superior mediastinum |
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Types of Retrosternal Goitre |
1.Substernal 2.Plunging 3.Intrathoracic |
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Clinical Features of Retrosternal Goitre |
Dysphagia Dyspnoea Engorgement of Neck Veins |
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What is Solitary Nodule? |
Swelling confined to one or the other lateral lobe /isthmus |
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Solitary Nodules Nature |
Cluster of nodules between 1-4 cm |
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Types of Needle Biopsy |
1. Fine Needle Aspiration Biopsy (21-25 gauge needle) 2. Large needle aspiration (16-18 gauge needle) 3. Cutting Needle Biopsy (Silvermann's Needles) |
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Grave's Disease |
Accumulation of Clinical Manifestations due to excess secretion of active thyroid hormones |
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Components of Grave's Disease |
1. Hyperthyroidism 2. Exophthalmus 3. Dermopathy called Pretibial Myxoedema |
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Blood Serum of Grave's Disease affected individuals show?? |
High Levels of TSH-RAb that binds to TSH receptor sites |
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Contributing factors of Grave's Disease |
Heredity - history in family Sex - Female 6:1 Emotional Disturbances - Stress |
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Pathology of Grave's Disease |
Thyroid (Hyperplastic) - Uniformly Enlarged, Smooth, Slight Nodularity Acini high columnar, less colloid/vacuolated, Nuclei with mitoses, Increasing vascularity around the Acini |
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Clinical Triad of Grave's Disease |
1.Thyrotoxicosis 2.Goitre 3.Exophthalmos |
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Is Goitre pronounced in Grave's? |
No |
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On palpation of Gland.. What are the findings? |
Smooth/irregular with nodularity and BRUIT of Thyroid |
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Symptoms of Thyrotoxicosis |
Extremely Excitable, Restless, Emotionally Unstable, Insomnia, Muscle Weakness, Wasting, Fatigue |
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Clinical Significant feature of Thyrotoxicosis |
TREMOR OF THE EXTENDED AAND ABDUCTED FINGERS |
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How are tendon reflexes? |
Hyperactive |
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Impact of high Calorigenesis in Thyrotoxicosis? |
Feel warmer, intolerance to heat, increased sweating, loss of weight even if high appetite is there |
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What is Secondary Thyrotoxicosis? |
Thyrotoxicosis that affects the previously affected Multinodular or Nodular Goitre |
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Features of Secondary Thyrotoxicosis? |
Marked Tachycardia, Resting Pulse over 80, Palpitation, Low diastolic pressure, High systolic pressure =Water Hammer Pulse, Atrial Fibrillation - Paroxysmal and then Continuous, CCD with ankle edema and Dyspnoea |
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Facial & Skin Changes in Thyrotoxicosis |
Warm Moist Face, Flushing and perspiration. Nail softened and fragile Clubbing of fingers and toes Hair fine and falls off during combing Gynecomastia due to hepatic dysfunction & incomplete metabolism of oestrogen Menses scanty/absent Libido Increased, Fertility Decreased |
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Pretibial Myxoedema |
Thickened Skin with mucin like deposit in lower part of leg, skin is red. Associated with exophthalmus and high TSH-RAb |
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Action of Thyrotoxicosis on GIT!? |
Diarrhoea, Increased frequency of defecation. Also hypercalcemia is seen |
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Ocular effects of Thyrotoxicosis |
Exophthalmus Spasm of upper eyelid with lid retraction Proptosis with widening of palpebral fissure SO, IO swelling Congestion, Chemosis, Oedema of Conjunctiva Papilloedema with Corneal Ulceration Weakness of extrinsic ocular muscles |
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Malignant Exophthalmus |
Oedema of eyelids, Chemosis, Congestion of Conjunctiva with venous congestion |
