Thyroid Diseases

Question 1

T4 seems to be preferentially INACTIVATED to reverse T3, rather than activated to T3 under what conditions?

Answer 1

starvation, steroid administration, or severe illness,

Question 2

What is euthyroid sick syndrome or non-thyroidal illness?

Answer 2

When T4 seems to be preferentially INACTIVATED to reverse T3, rather than activated to T3

Question 3

euthyroid sick syndrome (AKA non-thyroidal illness) is a common diagnosis in _________ patients.

Answer 3

hospitalized

Question 4

What are the hallmarks of Graves disease?

Answer 4

Toxic diffuse goiter, often with a bruit present.
Exophthalmos (eye pop)
pretibial myxedema

Question 5

What is Factitious or Iatrogenic Thyrotoxicosis:

Answer 5

Occurs when (excessive) Exogenous thyroid hormone shuts off pituitary TSH production and release and causes the thyroid gland to atrophy

Question 6

What is a Toxic Adenoma (“Hot Nodule”) of the thyroid?

Answer 6

overproduction of thyroid hormone by a nodule, this then suppresses pituitary TSH and the remainder of the thyroid gland shrinks.

Question 7

What is Subacute Thyroiditis (Giant Cell Thyroiditis, De Quervain’s Thyroiditis)?

Answer 7

viral infection of the thyroid, usually preceded by a viral upper respiratory infection that spread to the thyroid resulting in an externally sore throat (neck) with radiation of pain to the neck and ears.

Question 8

what are hallmarks of Subacute Thyroiditis (Giant Cell Thyroiditis, De Quervain’s Thyroiditis)?

Answer 8

The thyroid gland is swollen and tender

Question 9

describe key features of Silent Thyroiditis

Answer 9

1) (RAIU) is low at the time of hyperthyroidism.
2) thyroid gland is non-tender and the
3) disease does not follow viral illnesses;
4) the sedimentation rate is usually not elevated.
5) pathology is lymphocytic not granulomatous.

Question 10

What is Struma Ovarii?

Answer 10

hyperfunctioning thyroid tissue found in the ovaries.

Question 11

What is Jod-Basedow?

Answer 11

Iodide induced hyperthyroidism, particularly in areas of iodide deficiency. This has been recently noted with multinodular goiters as well.

Question 12

Explain why a Molar pregnancy may be associated with hyperthyroidism.

Answer 12

Molar pregnancies have high hCG levels, and hCG has weak agonist activity at the TSH receptor and therefore, can stimulate thyroid hormone production

Question 13

When the hypothyroidism is profound, it earns the title myxedema – this refers to _____

Answer 13

Diffuse nonpitting edema due to abnormal deposits of mucin in the skin, with thickened nose, lips and tongue

Question 14

Myxedema coma occurs when severe hypothyroidism leads to _______

Answer 14

decreased mental status and hypothermia