Thyroid Gland Disorders

Question 1

Anti-thyroid peroxidase Ab

Anti-Thyroglobulin Ab

Answer 1

Hashimoto’s

Question 2

TSH receptor antibody

Answer 2

Grave’s

Question 3

when do you tx subclinical hypothyroidism (high TSH, nml T4)

Answer 3

TSH >10

sxs

Question 4

RAIU finding: diffuse uptake

Answer 4

Graves

or TSH secreting pituitary adenoma

Question 5

RAIU finding: decreased uptake

Answer 5

thyroiditis (Hashimoto’s, etc)

Question 6

RAIU finding: HOT nodule

Answer 6

toxic adenoma

Question 7

RAIU finding: COLD finding

Answer 7

rule out malignancy

Cold= Cancer

Question 8

does hypo or hyperthyroidism cause hyperglycemia? which causes hypoglycemia

Answer 8

hyperthyroidism= hyperglycemia

Hypothyroidism= hypoglycemia

Question 9

What causes Ophthalmopathy:

Lid lag, _exophthalmos/proptosis**_

Pretibial Myxedema

Answer 9

Graves

Question 10

tx for Grave’s

Answer 10

• Radioactive iodine
• Methimazole or PTU
• BB (Propanolol)
• Thyroidectomy (if RAI CI, ex: preg)

Question 11

Is MMI or PTU preferred in preg

Answer 11

PTU- esp. in 1st trimester

Question 12

side effects of MMI and PTU

Answer 12

agranulocytosis and hepatitis

(Methimazole has less s/e, PTU preferred in preg)

Question 13

tx for thyroiditis (in general)

Answer 13

Aspirin

(most return to euthyroid state in 12-18mo)

Question 14

Painful thyroid s/p viral infection

Answer 14

de Quervain’s thyroiditis

Question 15

what lab finding is hallmark to de Quervain’s thyroiditis

Answer 15

Elevated ESR

(TFTs are usu. hyperthyr)

Question 16

Tx for de Quervain’s thyroiditis

Answer 16

Aspirin

Question 17

What 2 meds cause hypothyroidism

Answer 17

LITHIUM

amiodarone

Question 18

tx for medication induced hypothyroidism

Answer 18

corticosteroids

Question 19

MCC hypothyroidism in US?

In the world?

Answer 19

US–> Hashimoto’s

World–> Iodine deficiency

Question 20

What is the MC type of thyroid nodule

Answer 20

follicular adenoma (benign)

Question 21

What type of thyroid carcinoma is MC

Answer 21

Papillary

(MC after radiation exposure)

Question 22

Which type of thyroid carcinoma is is MC associated with MEN2

What do they secrete?

Answer 22

Medullary

secretes calcitonin

Question 23

which type of thyroid carcinoma is the most agressive?

What sxs does it often have?

Answer 23

anaplastic

compressive sxs

Question 24

Stones, bones, abdominal groans and psychiatric over tones

Decr. DTRs

Answer 24

Hypercalcemia

Question 25

Hypercalcemia + Incr. PTH + decr. Phosphate

+ Incr. 24hr urine calcium excretion

+ incr. vit D

Answer 25

primary hyperparathyroidism

Question 26

Trousseau’s & Chvostek’s signs

Incr. DTRs

Answer 26

hypocalcemia (could be sign of hypoparathyroidism)

Question 27

Hypocalcemia + Decr. PTH + incr. phosphate

Answer 27

hypoparathyroidism

Question 28

What is seen on EKG if hypocalcemia

(poss. seen in hypoparathyroidism)

Answer 28

prolonged QT

Question 29

What is seen on EKG if hypercalcemia

(poss. seen in hyperparathyroidism)

Answer 29

shortened QT

Question 30

tx for severe hypercalcemia

Answer 30

IV saline–> furosemide

Question 31

if someone has hypercalcemia related to hyperparathyroidism, what medication is contraindicated

Answer 31

Hydrochlorothiazide