Thyroid disorders Flashcards
(15 cards)
What is the number 1, almost always cause of hypothyroidism
Hashimoto thyroiditis
Other causes: Dietary deficiency in iodine, amiodarone
What are the symptoms of hypothyroidism
Everything slowed down except menstrual flow, which is increased
What is the order of tests you should do with hypothyroidism
First get TSH level. If this is low, then get T4 levels
What is the treatment for hypothyroidism
Thyroxine (synthroid)
What is the main complication of hypothyroidism and how is it treated
Myxedema Coma - thyroid storm equivalent
When infection happens with hypothyroidism, become hypothermic
Treatment: High dose T4 and now give T3 too, corticosteroids, IV fluids, and warming blankets
What are the five causes of hyperthyroidism and hints on the exam that these will be the causes
- ) Graves disease - Proptosis and skin findings, TSH receptor antibodies
- ) Subacute thyroiditis - Tender thyroid
- ) Painless silent thyroiditis: Nontender, normal exam
- ) Exogenous thyroid hormone - gland becomes small to the point where it is non-palpable
- ) Pituitary adenoma - high TSH
What is common between all forms of hyperthyroidism from all causes
Elevated T4 (TSH tests this time will be different because pituitary adenoma has increased TSH)
What is the difference between all forms of hyperthyroidism in terms of radioactive iodine uptake
Graves disease - elevated
Everything else - decreased
Pituitary adenoma - not done
What are diagnostic tools you can use to distinguish forms of hyperthyroidism
Graves - positive antibody testing
Subacute - tenderness
Painless - none
Exogenous thyroid - unpalpable gland
Pituitary adenoma - MRI of head
What is the treatments for hyperthyroidism in its chronic states
Graves - radioactive iodine Subacute - aspirin Painless - none Exogenous thyroid - stop use Pituitary adenoma - surgery
What is the treatment for acute hyperthyroidism
Propanolol - blocks target organ effect and peripheral conversion of T4 to T3
Methimazole and propylthiouracil - blocks hormone production
Iopianic acid and ipodate - blocks release of hormone and conversion of T4 to T3 (iodinated material)
Hydrocortisone
Radioactive iodine
What is the order of treatments if someone presents with graves opthalmology
Steroids - initial therapy
Decompressive surgery - if refractory
Find out if xt for this is different
What are thyroid nodules
Benign 95%, very rarely hyperfunctioning or hypofunctioning
What is the first step you must do if you discover a thyroid nodule
Measure TSH and T4 - if T4 high, then biopsy not needed because cancer is not hyperfunctioning
If TSH and T4 normal, then proceed to fine needle aspiration with biopsy
Ultrasound can be done but does not change treatments
After fine needle aspiration, what is the next step of the thyroid nodule management based on the results of the aspiration
Indeterminant: Remove nodule
Cancer: Remove nodule
