Thyroiditis Flashcards
non-viral infection of the thyroid gland
suppurative thyroiditis
in which patients is suppurative thyroiditis often found in?
immunosuppressed patients
why is the thyroid usually highly resistant to infection?
has high iodine concentration
a patient presents with a fever and painful, erythematous, fluctuant thyroid. they appear to be very sick. what are they likely experiencing?
suppurative thyroiditis
what labs would we get for a patient with suspicious suppurative thyroiditis? what will those labs look like?
ESR - elevated
WBCs - elevated
TSH - normal
T3/T4 - normal
in a patient with suppurative thyroiditis, why would TSH, T3, and T4 be normal?
it is not a thyroid cell problem, the thyroid itself is sick
what are 2 diagnostics to order for a patient with suspicious suppurative thyroiditis?
ultrasound
FNA biopsy + gram stain/culture
why would we want to order an ultrasound for a patient suspicious for suppurative thyroiditis?
look for swelling vs abscess
what is the treatment for suppurative thyroiditis?
empiric IV broad spectrum antibiotics
clindamycin
amoxicillin/clauvanate (augmentin)
what is an additional treatment for suppurative thyroiditis is the patient has an abscess?
surgical drainage
viral infection or a post-viral inflammatory process of the thyroid
subacute thyroiditis
a patient presents with an acutely tender, moderately large thyroid, pain that radiates to head and chest and is worse when coughing/moving. They also have a fever, fatigue, anorexia, and symptoms of hyperthyroidism. what are they likely experiencing?
subacute thyroiditis
a patient that is suspicious for subacute thyroiditis gets labs done. what should we expect to see if our suspicion is correct? (3)
varied TSH/T3, T4
elevated ESR
elevated CRP
if we got a histology on a patient with subacute thyroiditis, what would we expect to see? (4)
neutrophils
lymphocytes
histocytes
giant cells
what is the treatment for subacute thyroiditis? (3)
aspirin/NSAID for pain
beta blocker for thyrotoxicosis
levothyroxine for hypothyroidism
a patient with subacute thyroiditis is in severe pain. what medication should we give for pain control?
prednisone
what is the most common cause of hypothyroidism?
hashimoto thyroiditis
autoimmune disorder in which antibodies and antigen-specific T cells are directed against major thyroid antigens: thyroglobulin (Tg) and thyroid peroxidase (TPO)
hashimoto thyroiditis
what are 4 risk factors for hashimoto thyroiditis? (IAGE)
Iodine supplementation
Amiodarone
Genetics
Exposure to radiation
which medical condition may start as transient hyperthyroidism and then transitions into mild or subclinical hypothyroidism?
hashimoto thyroiditis
a patient presents with depression, chronic fatigue, xerostomia, keratoconjuntiva, and a diffusely large/firm thyroid. what are they likely experiencing?
hashimoto thyroiditis
what labs would we get for a patient that is suspicious for hashimoto thyroiditis? what will the results be? (4)
TSH - varies
T3/T4 - varies
anti-TPO - elevated
anti-TG - elevated
if a patient has had hashimoto thyroiditis for a while, what will their TSH, T3/T4 likely be?
TSH elevated
T3/T4 low
what diagnostic will help distinguish between multinodular goiter / Graves and hashimoto thyroiditis?
ultrasound
what is the treatment for hashimoto thyroiditis?
levothyroxine
