Thyroid

Question 1

elevated free T4, suppressed TSH

Answer 1

clinical hyperthyroidism

Question 2

normal free T4, suppressed TSH

Answer 2

sub-clinical hyperthyroidism

Question 3

very high TSH, low free T4

Answer 3

primary hypothyroidism

Question 4

normal/low TSH, low free T4

Answer 4

secondary/tertiary hyporthyroidism

Question 5

normal TSH, low free T4/T3

Answer 5

sub-clinical hypothyroidism

Question 6

Grave’s disease

Answer 6

thyrotoxicosis
most common c/o hyperthyroidism
goiter

Question 7

Grave’s disease treatment

Answer 7

antithyroid meds: methimazole, propylthiouracil, carbimazole

radioactive iodine: most common, hypothyroid for 6 weeks

surgery: very large glands

Question 8

thyroid storm

Answer 8

underlying hyperthyroidism
stress event/infx
tach, eryth, delirium, coma, death
fatal w/o treatment

Question 9

thyroid storm treatment

Answer 9

methimazole, propylthiouracil (inh synth)
sodium iodide, potassium iodide (inh release)
steroids
beta-blockers

Question 10

Hashimoto’s thyroiditis

Answer 10

most common hypothyroidism in US
TPO Ab+
T3/T4 low, low/normal
TSH elevated

Question 11

subclinical hypothyroidism

Answer 11

NOT TPO Ab+

Question 12

subacute thyroiditis

Answer 12

autoimmune secondary to viral infx

thyrotoxic–>hypothyroid–>euthyroid

Question 13

symptomatic hypothyroid treatment

Answer 13

levothyroxine (exogenous T4)

Question 14

Myxedema coma

Answer 14

decompensated hypothyroidism secondary to sepsis/MI/CVA/etc

Question 15

myxedema coma treatment

Answer 15

IV levothyroxine
steroids
warming blankets
IV Abx (if bacterial etiology)

Question 16

post-partum thyroiditis

Answer 16

excessive T4–>T3 conversion

self-limiting Dz

Question 17

Thyroid nodules

Answer 17

white->cold->malignant

dark->hot->benign

Question 18

papillary thyroid cancer

Answer 18

80% thyroid cancers

good prognosis

Question 19

anaplastic thyroid cancer

Answer 19

rare

poor prognosis