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Flashcards in Thyroid disorders Deck (15):

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

1.) Graves disease - Proptosis and skin findings, TSH receptor antibodies
2.) Subacute thyroiditis - Tender thyroid
3.) Painless silent thyroiditis: Nontender, normal exam
4.) Exogenous thyroid hormone - gland becomes small to the point where it is non-palpable
5.) 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)

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