OME Thyroid

Question 1

T4 Function

Answer 1

MOve, Mentation, Metabolism

Question 2

Hyperthyroid sx

Answer 2

Tachycard
Diarrhea (active bowel)
Heat intolerance
increase DTR
Wt Loss
Afib.

Question 3

Hyperthyroid DX

Answer 3

1st TSH
FT4
Best: RAIU

Question 4

GRaves DX and TX

Answer 4

DX: Thyroid stimulating Ab
Thionamides: PTU (pregnant), Methimazole.

If you use radio and surgery watch Exophthamos and pretibial Myxedema. They may get worse, so use surgery and steroids.

Question 5

Thyroiditis

Answer 5

Thyroid will break open and transient hyperthyroid.

If fixes itself then returns to normal. If not Hashimoto’s.

If tender than DeQuevian- infection, etc.
If nontender- Hashimoto’s or autoimmune etc.

Question 6

Multinodular goiter and Toxic Adenoma

Answer 6

RAIU will show nodules hot

Question 7

Factitious and Stroma Ovarii

Answer 7

Cold Thyroid on RAIU

Get a Sestamibi scan of ovaries before confronting pt in medical field trying to lose weight.

Question 8

RAIU summary

Answer 8

Graves- diffuse uptake
Thyroiditis- Cold thyroid
MNG/ Toxic Adenoma - Nodules
Factitious + Stroma Ovarri- Cold

Question 9

Thyroid Storm

Answer 9

Afib/Shock
Fever >or = 104
Hypotensive
AMS

TX: In order
IVF and Cooling Blanckets
Propranolo
PTU/Methimazole
Steroids (to reduce conversion of T4 to T3)

Question 10

HyperThyroid TX

Answer 10

Surgery- Graves

Radioactive I2 Ablation- MNG+Toxic Adenoma, Stroma Ovarii.

Question 11

Hypothyroids

Answer 11

Most common cause is Iatrogenic (treating Graves)
then Hashimoto’s.

TX: Levothyroxine

Sxs: Bradycardia, Constipation, Cold intolerance, Dec DTR, Weight Gain

If Subclinical (TSH is up, but no symptoms): When TSH is greater than 10 treat, or if they gain symptoms.

Doesn’t matter cause of hypothyroid, just treat.

Question 12

Myxedema Coma

Answer 12

Coma
Hypothermia
Hypotension (like thyroid storm)

Tx: IVF (warm), Warming blankets, IV T4 (if that doesn’t work IV T3)