Thyroid dysfunction

Question 1

1. Identify the major symptoms and signs of hyperthyroidism.

Answer 1

Nervousness		84%
	Weight Loss		51%
	Increased Appetite	57%
	Decreased Appetite	4%
	Fatigue			84%
	Tremor			84%
	Heat Intolerance		92%

Question 2

2. List the disorders leading to hyperthyroidism.

Answer 2

High Uptake Hyperthyroidism

Thyrotropin receptor antibody
-Graves’ disease
Thyroid autonomy
-Toxic adenoma
-Toxic multinodular goiter (MNG)

Low Uptake “Hyperthyroidism
-Subacute thyroiditis
—–Granulomatous thyroiditis (viral); de Quervain’s
-Chronic lymphocytic thyroiditis (Hashimoto’s)
—–Postpartum thyroiditis
Ectopic thyrotoxicosis
-Factitious

Question 3

3. Recognize the major symptoms and signs of hypothyroidism.

Answer 3

Mental Slowness		68%
Weight Gain		58%
Decreased Appetite	50%
Fatigue			83%
Muscle Cramps		55%
Cold Intolerance		65%

Question 4

4. Name the conditions leading to hypothyroidism.

Answer 4

Primary Hypothyroidism

Chronic autoimmune (Hashimoto’s) thyroiditis

Transient hypothyroidism

• Silent or postpartum thyroiditis
• Subacute or granulomatous thyroiditis

Iatrogenic

• Thyroid surgery/thyroidectomy
• Radioactive iodine

Central Hypothyroidism (2˚/3˚)
-Pituitary tumor

Question 5

5. Interpret the different tests used to evaluate thyroid function.

Answer 5

TSH

• increased means low T3 or TSH secreting tumor
• decreased means high T3, or pituitary trauma

Radioactive Iodide uptake

• If TSH is suppressed, there should be no uptake of iodine.
• normal/ elevated iodine uptake in the setting of a low TSH is abnormal and indicates autonomous production of thyroid hormone = true hyperthyroid state.
• If uptake is low (appropriately so, in the setting of a low TSH), then thyroid hormone excess is due to high release of preformed thyroid hormone.

Thyroid scan – pattern gives info
on etiology of high uptake
(Graves’ vs. hot nodule vs.
multinodular goiter)

Question 6

Whats The single best test to screen for thyroid dysfunction

Answer 6

TSH level

Question 7

what is thyrotoxicosis

Answer 7

Thyrotoxicosis

high levels of circulating thyroid hormone