Chapter 57: Thyroid Gland- Thyroiditis Flashcards
What are the features of acute thyroiditis?
Painful, swollen thyroid; fever; overlying skin erythema; dysphagia
What is the cause of ACUTE thyroiditis?
Bacteria (usually Streptococcus or Staphylococcus), usually caused by a thyroglossal fistula or anatomic variant
What is the treatment of ACUTE thyroiditis?
Antibiotics, drainage of abscess, needle aspiration for culture; most patients need definitive surgery later to remove the fistula
What are the features of SUBACUTE thyroiditis?
Glandular swelling, tenderness, often follows URI, elevated ESR
What is the cause of SUBACUTE thyroiditis?
Viral infection
What is the treatment of SUBACUTE thyroiditis?
Supportive: NSAIDS, ± steroids
What is De Quervain’s thyroiditis?
Just another name for subacute thyroiditis caused by a virus (Think: DeQuerVain = Virus)
How can the differences between etiologies of ACUTE and
SUBACUTE thyroiditis be remembered?
Alphabetically: A before S, B before V (i.e., Acute before Subacute and Bacterial before Viral, and thus: Acute = Bacterial and Subacute = Viral)
What are the common causative bacteria in acute suppurative
thyroiditis?
Streptococcus or Staphylococcus
What are the two types of chronic thyroiditis?
- Hashimoto’s thyroiditis
- Riedel’s thyroiditis
What is Riedel’s thyroiditis?
- Benign inflammatory thyroid enlargement with fibrosis of thyroid
- Patients present with painless, large thyroid
- Fibrosis may involve surrounding tissues
What is the treatment for Riedel’s thyroiditis?
Surgical tracheal decompression, thyroid hormone replacement as needed—possibly steroids/tamoxifen if refractory
Name the diagnostic stimulation test for the following:
Medullary thyroid carcinoma?
Pentagastrin (also calcium)
Name the most likely diagnosis:
60-year-old woman with a thyroid mass, + follicular cells on
biopsy, + capsular invasion, + vascular invasion
Thyroid follicular carcinoma
42-year-old woman with thyroid mass, + amyloid on histology,
hypercalcemia
Medullary thyroid carcinoma
