Thyriod Flashcards
Management for sub clinical hypothyriodism?
TSH 4-10
- <65 with hypothyroid symptoms- trail of levothyroxine (no improvement, stop levothyroxine)
- > 80/older - watch and wait
- Asymptomatic - observe and repeat in 6 months,
TSH >10
<70 - start levothyroxine
Older - watch and wait
How does de quervains subacute thyroiditis present?
Tender, enlargement of thyroid goitre, with Hyperthyriodism and raised ESR
Followed by euthyroid and hypothyroidism weeks-months later —- returns to normal.
Main investigation for subacute thyroiditis?
Technetium thyroid scan (iodine 131) - shows globally decreased uptake
Which antibodies are present in hasimotos thyroiditis?
Anti-thyroid peroxidase ABs (TPO)
Anti- Thyroglobulin ABS
Anti- microsomal ABS
What are the thyroid levels in sick euthyroid syndrome?
TSH low or normal
T4 and t3 low
Which is the most common type of thyroid cancer?
Papillary
Females
Nodules
Lymphatic spread (LNs raised)
Good prognosis
Which thyroid cancer is in MEN 2?
Medullary
Parafollicular (C) cells - secret calcitonin
What antibodies are present Graves’ disease?
TSH receptor stimulating antibodies (90%)
Anti-thyroid peroxidase antibodies (75%)
What Are the features of Graves’ disease?
Thyrooxicosis : tremor, palpitations, anxiety,
Specific to Graves :
Eye signs: exophalmos, opthalmoplegia
Pretibial myxedema
How is papilllary thyroid cancer diagnosed?
Biopsy showing psammoma calcification
Clue: young woman, with history of lymphadenopathy
In multi nodular goitre what do you see in the TFTs?
Can be Hyperthyroid, euthyroid or hypothyroid!
How does follicular cancer of thyroid spread?
Haematological route
Mets to lungs and bones
