OnlineMedEd: Endocrine - "Thyroid"

Question 1

List the symptoms of hyperthyroidism.

Answer 1

• Tachycardia
• Diarrhea
• Fatigue
• Heat intolerance
• Weight loss
• Increased DTRs
• Atrial fibrillation
• Panic attacks

Question 2

The thyroid of someone with ______________ will be uniformly enlarged and absorb iodine uniformly.

Answer 2

Grave’s disease

Question 3

Unlike most other kinds of hyperthyroidism, Grave’s disease responds well to ______________.

Answer 3

medical therapy (thionamides: propylthiouracil and methimazole)

Question 4

Thyroiditis can lead to what two states after time?

Answer 4

• Normalcy (if the thyroid heals)

* Hashimoto’s (if the thyroid is destroyed)

Question 5

Toxic adenoma is called ____________ if there are more than one.

Answer 5

multinodular goiter

Question 6

Struma ovarii can be mistaken for what other disorder?

Answer 6

Factitious use of T4

The way to differentiate these two is with imaging of the ovaries.

Question 7

Review the presentation of thyroid storm.

Answer 7

• Tachycardia
• Atrial fibrillation
• Fever to greater than 104
• AMS
• Hypotensive

Question 8

How should thyroid storm be treated?

Answer 8

• Cool IVF and cold blankets if their temp is greater than 104
• Beta-blockers
• PTU/methimazole
• Steroids

Question 9

Review the treatments for the different kinds of hyperthyroidism.

Answer 9

• MNG, adenoma, struma ovarii: radioactive I2
• Graves: PTU, methimazole; surgery if those fail

Note: radioactive iodine can make exophthalmos worse in Grave’s, so do not use it.

Question 10

Review the symptoms of hypothyroidism.

Answer 10

• Bradycardia
• Constipation
• Cold intolerance
• Fatigue
• Weight gain
• Decreased DTRs

Question 11

_______________ antibodies are seen in Hashimoto’s, though they don’t matter in terms of treatment.

Answer 11

Thyroperoxidase

Question 12

When do you treat subclinical hypothyroidism?

Answer 12

• When the TSH is greater than 10

* When symptoms develop

Question 13

What is subclinical hypothyroidism?

Answer 13

Elevated TSH with normal T4

Question 14

What lab can distinguish thyroiditis from factitious use of T4?

Answer 14

Thyroglobulin will be high in thyroiditis because it spills out of the damaged thyroid, while it will be low in factitious use because it suppresses endogenous release of T4.

Question 15

Describe the symptoms of myxedema coma.

Answer 15

• Coma
• Hypothermia
• Hypotension

Question 16

How is myxedema coma treated?

Answer 16

• IVF
• Blankets (warm)
• IV T4/T3

Question 17

True or false: the metabolically active form of thyroid hormone is T4.

Answer 17

False

T3 is the active form.