NCM 116 - THYROID

Question

Answer

What is hyperthyroidism?

A condition of excess thyroid hormone (T3/T4) leading to a hypermetabolic state commonly due to Graves’ disease.

What is hypothyroidism?

A condition of deficient thyroid hormone resulting in decreased metabolic activity commonly due to Hashimoto’s thyroiditis.

What is the function of T3 and T4?

They regulate metabolism heat production heart rate and CNS activity.

How is thyroid function regulated?

Through the HPT axis TRH to TSH to T3/T4 with negative feedback.

What is the most common cause of hyperthyroidism?

Graves’ disease autoimmune.

What is the most common cause of hypothyroidism?

Hashimoto’s thyroiditis autoimmune destruction.

What lab pattern indicates primary hyperthyroidism?

Low TSH and high T3/T4.

What lab pattern indicates primary hypothyroidism?

High TSH and low T4.

Which test is most sensitive for thyroid dysfunction?

TSH level.

What is thyrotoxicosis?

Clinical syndrome caused by excess circulating thyroid hormones.

What are key symptoms of hyperthyroidism?

Weight loss heat intolerance palpitations tremors anxiety diarrhea.

What are key symptoms of hypothyroidism?

Fatigue weight gain cold intolerance constipation depression.

What is exophthalmos?

Protrusion of the eyes seen in Graves’ disease.

What is myxedema?

Non-pitting edema due to mucopolysaccharide accumulation in hypothyroidism.

What cardiovascular signs are seen in hyperthyroidism?

Tachycardia atrial fibrillation increased systolic BP.

What cardiovascular signs are seen in hypothyroidism?

Bradycardia and reduced cardiac output.

What GI symptoms occur in hyperthyroidism?

Diarrhea and increased appetite.

What GI symptoms occur in hypothyroidism?

Constipation.

What skin findings are seen in hyperthyroidism?

Warm moist skin.

What skin findings are seen in hypothyroidism?

Dry coarse skin.

What are key positive history findings for hyperthyroidism?

Weight loss palpitations heat intolerance.

What are key positive history findings for hypothyroidism?

Fatigue weight gain cold intolerance.

What are risk factors for Graves’ disease?

Female sex stress autoimmune conditions.

What are risk factors for hypothyroidism?

Autoimmune disease thyroid surgery iodine imbalance.

What is an important negative history in hyperthyroidism?

Absence of weight gain and cold intolerance.

What is an important negative history in hypothyroidism?

Absence of palpitations and heat intolerance.

What can trigger thyroid storm?

Infection surgery or stress.

Who is at risk for myxedema coma?

Elderly patients with untreated hypothyroidism.

What functional risk is seen in hypothyroidism?

Activity intolerance.

What cardiac risk is associated with hyperthyroidism?

Atrial fibrillation.

What is the first-line investigation for thyroid disease?

TSH measurement.

What confirms hyperthyroidism on labs?

Elevated T3 and T4 levels.

What confirms hypothyroidism on labs?

Low T4 level.

What test identifies Graves’ disease?

TSH receptor antibodies.

What is radioactive iodine uptake RAIU used for?

To assess thyroid activity increased in Graves’ disease.

What imaging evaluates thyroid structure?

Thyroid ultrasound.

What ECG finding is seen in hyperthyroidism?

Tachycardia or atrial fibrillation.

What ECG finding is seen in hypothyroidism?

Bradycardia.

What lipid changes occur in hypothyroidism?

Increased cholesterol levels.

Why are antibodies checked in hypothyroidism?

To confirm autoimmune cause Hashimoto’s.

What is the first-line treatment for hypothyroidism?

Levothyroxine replacement therapy.

What are first-line drugs for hyperthyroidism?

Methimazole or propylthiouracil PTU.

What is the role of propranolol in hyperthyroidism?

Controls symptoms like tachycardia and tremors.

What is the mechanism of PTU?

Inhibits thyroid hormone synthesis and blocks T4 to T3 conversion.

What is the definitive treatment for hyperthyroidism?

Radioactive iodine therapy.

What is the emergency complication of hyperthyroidism?

Thyroid storm.

What is the emergency complication of hypothyroidism?

Myxedema coma.

What nursing care is needed for hyperthyroidism?

Provide a cool environment high-calorie diet and reduce stimulation.

What nursing care is needed for hypothyroidism?

Provide warmth encourage gradual activity and prevent complications.

What is a key UK guideline principle in thyroid management?

Regular TSH monitoring and lifelong follow-up.