Hypothyroidism

Question 1

Causes

Answer 1

1) Hashimoto’s thyroiditis
2) Cretinism
3) Subacute thyroiditis (de Quervain’s)
4) Riedel’s thyroiditis
5) Others

Question 2

Hashimoto’s

characteristics

Answer 2

1) Most common cause of hypothyrodism
2) Autoimmune: thyroid peroxidase, antithyroglobulin
3) HLA-DR5 (along with pernicious)
4) Increased risk of non-Hodgkin’s
5) Maybe hyperthyroid early in course

Question 3

Hashimoto

histology and finding

Answer 3

Hurthle cells,
lymphocytic infiltrates with germinal centers

Finding: moderated enlarged nontender thyroid

Question 4

Cretinism:

Characteristics

Answer 4

1) Due to severe fetal hypothyroidism
2) Endemic cretinism with endemic goiter
3) Sporadic cretinism by defect in T4 formation/developmental thyroid formation

Question 5

Cretinism:

finding

Answer 5

1) pot bellied
2) pale
4) puffy faced
5) protruding umbilicus
6) protuberant tongue

Question 6

Subacute thyroiditis (de Quervain's)
Characteristics

Answer 6

1) Self limited hypothyroidism often following flu like illness
2) Maybe hyperthyroid early in course

Question 7

Subacute thyroiditis (de Quervain's)
Histology and finding

Answer 7

Histology: granulomatous inflammation
Finding: high ESR, jaw pain, early inflammation,
VERY TENDER thyroid (vs. Hashimotos)

Question 8

Riedel’s thyroiditis

characteristics

Answer 8

1) Thyroid replaced by fibrous tissue (hypothyroid)

2) Considered a manifestation of IgG4 related systemic disease

Question 9

Riedel’s thyroiditis

Finding

Answer 9

Fixed,
hard (rock like) and
PAINLESS goiter.

Question 10

Other causes

Answer 10

1) Congenital hypothyroidism
2) Iodidine deficiency
3) Goitrogens
4) Wolff-Chaikoff effect
5) Painless thyroiditis