Most common cause of thyrotoxicosis in US? Physical exam sign that is suggestive?
Most common cause of hyperthyroidism postpartum? Mechanism?
Graves Disease, diffusely enlarged goiter
Destructive lymphocytic thyroiditis; high corticosteroid levels and pregnancy suppress autoimmune antibodies, resulting in a flare postpartum
Thyroid storm?
Thyrotoxicosis leading to
- CNS dysfunction (coma/altered mental status)
- Autonomic instability (hyperthermia, hypertension, hypertension)
biologically active thyroxine hormone?
T3
Treatment of hyperthyroidism during pregnancy?
PTU > methimazole > radioactive iodine
methimazole possibly associated with plasia cutis congenital – Skin/scalp defects
Tx of thyroid storm?
- PTU
- Beta blockers to control tachycardia
- Acetaminophen/cooling blankets for hyperthermia
- Steroids to prevent conversion of T4 to T3
Antenatal treatment of maternal hyperthyroidism in pregnancy can result in? Management?
Failure to treat may result in?
Fetal hyper- or hypothyroidism. Maternal administration PTU or Intra-amniotic injection of thyroxine for fetal hyper- and hypothyroidism respectively
Non-immune hydrops and fetal demise
Effect of maternal subclinical hypothyroidism in children? Possible prevention?
Adverse neurological development/abnormal intelligence
Levothyroxine in the first trimester
Effect of pregnancy on thyroid hormones? Changes due to?
Increase in thyroid-binding globulin and total T4
No Change in free T4 or TSH
Estrogen
Antibodies seen in destructive lymphocytic thyroiditis?
Antimicrosomal and anti-peroxidase
