Hypothyroidism

Question 1

Describe chronic autoimmune thyroiditis

Answer 1

-Presentation: tiredness, cold intolerance, weight gain, dry skin, impaired cognition. Firm, non-tender goitre. Other autoimmune conditions.

-Investigations: thyroid function, thyroid ultrasound, thyroid antibodies (TPO, Tg)

-Management: levothyroxine

Question 2

Drug causes of hypothyroidism

Answer 2

-Amiodarone, sulfonylureas, thalidomide, interleukin, lithium, interferon-alpha therapy

Question 3

Describe central hypothyroidism

Answer 3

-Presentation: MEN, head, and neck irritation, TBI, decreased memory

-Investigation: pituitary MRI, head CT

-Management: levothyroxine, treatment of underlying pituitary tumour (dopamine agonist, somatostatin analogues, surgery)