thyroid disorders Flashcards
1
Q
overt vs subclinical primary hypothyroidism
- how to differentiate
A
overt will have raised TSH, low T4
subclinical will have raised TSH but normal T4
2
Q
management of primary hypothyroidism
- which types should be commenced on treatment immediately (consider symptoms, overt vs subclinical)
A
treat immediately if symptomatic
if not, dither and procrastinate
3
Q
hyperthyroidism - ddx (7)
A
autoimmune
- grave’s disease
tumor
- toxic multinodular goitre
- thyroid adenoma
inflammatory
- painless sporadic thyroiditis
- subacute thyroiditis
medication related
- drug-induced hyperthyroidism -(amiodarone)
- exogenous hormone replacement
4
Q
hyperthyroidism
- indications for imaging
- what imaging to do
A
if TSH suppressed, and raised T3 or T4
do a tec-99 radionuclide scan
5
Q
hyperthyroidism - tec99 findings in
- grave’s disease
- thyroid adenoma
- toxic multinodular goitre
- subacute thyroiditis
- exogenous supplementation
- drug induced thyroiditis
- painless sporadic thyroiditis
A
graves - homogenous uptake
thyroid adenoma - single spot uptake
toxic multinodular goitre - heterogenous uptake
the rest will have no uptake
6
Q
hyperthyroidism - no uptake on tec-99
- ddx (4)
- which are painful and which are painless
A
- subacute thyroiditis (painful)
- exogenous supplementation
- drug induced thyroiditis
- painless sporadic thyroiditis
