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SMLE | Endocrine 🧪 > Thyroid > Flashcards

Thyroid Flashcards

1
Q

3 specific signs to Grave’s disease:

A
  1. Peritibial myxedema
  2. Exophthalmos
  3. Goiter with thyroid bruit
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2
Q

What autoimmune antibodies are likely positive in Grave’s disease?

A

Thyroid stimulating Immunoglobulin (TSI)
“TSH receptor AB”

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3
Q

What autoimmune antibodies are likely positive in Hashimoto’s thyroiditis?

A

Anti-peroxidase
Anti-thyroglobulin

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4
Q

Painful tender thyroid
Jaw pain
High ESR
What is the most likely diagnosis

A

Subacute thyroiditis

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5
Q

Medications may cause hyperthyroidism […]

A

Amiodarone
Lithium

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6
Q

Focal patches of hyperfunctioning follicular cells with colloid working independently of TSH

A

Toxic Multinodular goiter
“Plummer disease”

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7
Q

In case of hyperthyroidism with low RAIU what is the likely diagnosis ?

A

🔹Transient thyroiditis
🔹Extrathyroidal T4

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8
Q

Primary hyperthyroidism
[…] TSH […] T4 […] T3

A

Primary hyperthyroidism
🔻 TSH 🔺 T4 🔺 T3

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9
Q

Secondary hyperthyroidism
[…] TSH […] T4 […] T3

A

Secondary hyperthyroidism
🔺 TSH 🔺 T4 🔺 T3

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10
Q

Subclinical hyperthyroidism
[…] TSH […] T4 […] T3

A

Subclinical hyperthyroidism
🔻 TSH 🟢 T4 🟢 T3

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11
Q

What is the First line treatment of Grave’s disease?

A

Methimazole

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12
Q

Hyperthyroidism in pregnancy treatment

A

1st trimester: PTU
2nd & 3rd: Methimazole

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13
Q

What are the side effects of thionamides?

A
  • Agranulocytosis
  • skin rash
  • hepatotoxicity
  • arthralgia
  • Methimazole (Teratogenic)
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14
Q

What is the approach of starting Methimazole treatment

A

Start with 10 mg
If not improved increase to 20
If not improved increase to 40
If not improved RAI

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15
Q

Follow up thyroid function at week […] after starting methimazole

A

6

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16
Q

Management of Subacute thyroiditis:

A

NSAIDs
Steroids

17
Q

Management of Multinodular toxic goiter & toxic adenoma:

A

RAI (1st line)
Surgical thyroidectomy

18
Q

Primary hyporthyroidism
[…] TSH […] T4 […] T3

A

Primary hyporthyroidism
🔺 TSH 🔻 T4 🔻 T3

19
Q

Secondary hyporthyroidism
[…] TSH […] T4 […] T3

A

Secondary hyporthyroidism
🔻 TSH 🔻 T4 🔻 T3

20
Q

Subclinical hyporthyroidism
[…] TSH […] T4 […] T3

A

Subclinical hyporthyroidism
🔺 TSH 🟢 T4 🟢 T3

21
Q

Hypothyroidism treatment of choice:

A

Levothyroxine

22
Q

At lease […] weeks should pass before repeating Thyroid function test and adjusting levothyroxine dose

A

6

23
Q

When should you treat subclinical hypothyroidism ?

A

🔸 Symptomatic
🔸 TSH >10 mU/L
🔸 Pregnancy

24
Q

Bethesda categories .. management

A

I “nondiagnostic” : repeat FNA
II “benign” : follow up U/S
III “AUS/FLUS” : repeat FNA
IV “sus follicular neoplasm” : Lobectomy
V “sus malignancy” : Lobectomy vs near total thyroidectomy
VI “malignant” : near total thyroidectomy

25
Q

What are the steps to approach a thyroid nodule (after detailed history & PE) :

A
  1. TSH
  2. US
  3. FNA
  4. Bethesda classification
26
Q

The most common thyroid cancer subtype […]

A

Papillary

27
Q

Papillary thyroid cancer metastasis through […] most common metastasis to […]

A

Lymph nodes
Lungs 🫁

28
Q

Follicular thyroid cancer metastasis through […] most common metastasis to […]

A

Hematogenous
Bone 🦴

29
Q

[…] thyroid cancer associated with MEN syndrome

A

Medullary
MEN 2A/B

30
Q

Medullary thyroid cancer produces […]

A

Calcitonin

31
Q

Thyroid storm Treat with:

A

PTU
Proprinolol
Prednisolone
Potassium iodide

32
Q

Wolff-Chaikoff effect

A

Autoregulation thyroid gland ⛔️ Thyroid peroxidase in response to excess iodide

33
Q

Jod-Basdow phenomenon

A

Iodine-induced hypethyroidism due to autonomous thyroid tissue
Induced by : amiodarone , iodine IV contrast

34
Q

56 years old female patient with hypothyroidism on thyroxine 175 mcg for 10 months, then the dose was increased to 200. Her labs show high TSH normal T4. What is the most likely explanation?

A

Medication non-compliance

35
Q

Sick Euthyroid syndrome

A

“Low T3” syndrome
T3 🔻🔻
rT3 🔺🔺
T4 🟢/🔻
TSH 🟢/🔺

SMLE | Endocrine 🧪 (5 decks)

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