Thyroid

Question 1

What is the most common cause of thyrotoxicosis

Answer 1

Grave’s disease

Question 2

When to suspect De Quervain’s (aka subacute thyroiditis) over Grave’s disease

Answer 2

Thyrotoxicosis with a tender goitre

Question 3

When does De Quervain’s occur and how does it present

Answer 3

It occurs following a viral illness
And it typically presents with hyperthyroidism (and a tender goitre)

Question 4

What are the 4 phases of De Quervain’s

Answer 4

blehhhh

Question 5

How to diagnose De Quervain’s

Answer 5

Thyroid scintigraphy = globally reduced uptake of iodine

Question 6

Management of De Quervain’s

Answer 6

• Usually self limiting - most patients don’t require treatment
• Thyroid pain may respond to aspirin or other NSAIDs
• In more severe cases can give steroids esp if hypothyroidism develops

Question 7

What are the different patterns on thyroid scintigraphy

Answer 7

1. globally reduced iodine uptake = De Quervain’s

Question 8

What is Hashimoto’s

Answer 8

It is a chronic autoimmune disorder of the thyroid gland associated with hypothyroidism
hashimOtO’s -> hypOthyroid
But note there may be a transient thyrotoxicosis in the acute phase

Question 9

Who is Hashimoto’s more common in

Answer 9

10x more common in Women

Question 10

Features of Hashimoto’s

Answer 10

• Features of hypothyroidism
• Goitre (firm and non tender)
• Anti-thyroid peroxidase (TPO) enzymes and anti thyroglobulin (Tg) antibodies

Question 11

Associations with Hashimotos

Answer 11

1. Other autoimmune conditions e.g. Coeliac, T1DM, Vtiligo etc
2. MALT lymphoma