Small Group: Thyroid Disorders

Question 1

What are signs and symptoms of hyperthyroidism?

Answer 1

Heat intolerance
Weight loss
Palpitations
Diarrhea
Thinning of lateral eyebrow hair
Irritability
Insomnia
Diplopia
Diaphoresis
Tremor
Smooth skin
Tachycardia
Lid lag (eyelids pulled back slightly due to increased muscle tone)

Question 2

In most cases, hyperthyroidism can be confirmed with only ____________.

Answer 2

TSH level (suppressed)

Question 3

Graves disease is treated with ______________.

Answer 3

radioactive iodine

Question 4

What might you hear in listening to someone with hypothyroidism (in their voice)?

Answer 4

Hoarseness due to thickening of the vocal cords

Question 5

Why do women with hypothyroidism have heavy menstrual bleeding?

Answer 5

Sex-hormone binding globulin is produced by the liver in response to thyroid hormone, so deficient levels lead to increased free estrogen.

Question 6

What neurologic sign is suggestive of hypothyroidism?

Answer 6

Slow or absent deep tendon reflexes

Question 7

Describe silent thyroiditis.

Answer 7

In pregnancy, women undergo a transient immunosuppressive state. After pregnancy, this ends and the immune system can attack the thyroid. This results in temporary hyperthyroidism –due to the release of preformed thyroid hormone –followed by hypothyroidism.

This is distinguished from subacute thyroiditis by being painless.

Question 8

How can silent thyroiditis be differentiated from Sheehan’s syndrome?

Answer 8

Sheehan’s hypothyroidism presents with low TSH (because the pituitary is damaged), while silent thyroiditis hypothyroidism presents with high TSH.

Question 9

True or false: treat non-thyroidal sick syndrome with thyroxine.

Answer 9

False. Thyroid hormone supplementation has not been shown to improve outcomes of those with euthyroid sick syndrome.

Question 10

What non-thyroid lab values can help diagnose subacute thyroiditis?

Answer 10

Elevated ESR