Thyroiditis Flashcards

1
Q

def

A

inflammation of the thyroid

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2
Q

does thyroiditis cause high or low thyroid hormones

A

can be either

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3
Q

what are the common forms of thyroiditis

A
AUTOIMMUNE THYROIDITIS
1 Hashimoto's thyroiditis (most common)
2 past partum thyroiditis
3 silent or painless thyroiditis
NON-AUTOIMMUNE THYROIDITIS
1 de quervains thyroiditis AKA granulomatous thyroiditis
2 drug or radiation induced thyroiditis
3 acute or infectious thyroiditis
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4
Q

what is hashimotos thyroiditis

A

autoimmune condition in which the thyroid gland is slowly destroyed

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5
Q

what causes hashimotos thyroiditis

A

genetic and environmental factors which causes antithyroid antibodies which attack the thyroid

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6
Q

epi of hashimotos thyroiditis

A

most common cause of hypothyroidism

women>men

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7
Q

history + examination of hashimotos thyroiditis

A
history
-symptoms of hypothyroidism
examination
-signs of hypothyroidism
-painless goitre
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8
Q

investigations of hashimotos thyroiditis

A

antibodies against thyroid peroxidase

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9
Q

risk factors of hashimotos thyroiditis

A

family history of condition

autoimmune disease

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10
Q

management of hashimotos thyroiditis

A

levothyroxine

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11
Q

complications of hashimotos thyroiditis

A

thyroid lymphoma

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12
Q

prognosis of hashimotos thyroiditis

A

generally good

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13
Q

what is post-partum thyroiditis

A

observed after pregnancy which gives hyperthyroidism, hypothyroidism or the two sequentially

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14
Q

epi of post-partum thyroiditis

A

uncommon in post-partum women

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15
Q

aetiology of post-partum thyroiditis

A

due to changes in the immune system in pregnancy this causes antithyroid antibodies

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16
Q

prognosis of post-partum thyroiditis

A

known as the resolving thyroiditis

17
Q

history + examination of post-partum thyroiditis

A

hyperthyroidism usually occurs first followed by hypothyroidism (which is generally more severe so is when patients present)

18
Q

investigations of post-partum thyroiditis

A

a suppressed TSH could indicate the hyperthyroid phase

a low T3/4 with raised TSH could indicate the hypothyroid phase

19
Q

management

A

the hyperthyroid phase is generally quite mild and may require beta-blockers or nothing
the hypothyroid phase is more severe and if the TSH is very high, levothyroxine may be required

20
Q

silent or painless thyroiditis

A

inflammation of the thyroid gland
autoimmune reaction against the thyroid gland leading to hyperthyroidism followed by hypothyroidism
women>men
symptoms + signs of hyperthyroidism followed by symptoms + signs of hypothyroidism
TFTs

21
Q

what is de quervains thyroiditis

A

AKA as subacute granulomatous thyroiditis

it is painful thyroiditis

22
Q

aetiology of de quervains thyroiditis

A

can be preceded by URTI

viral causes include coxsackie, mumps, adenoviruses

23
Q

history + examination

A

hyperthyroid phase followed by a hypothyroid phase
symptoms of hyperthyroidism followed by symptoms of hypothyroidism
there may be painful dysphagia

24
Q

investigation

A

similar presentation to diffuse toxic goiter or graves disease
radionuclide thyroid uptake:
-decreased uptake in thyroiditis
-increased uptake in graves disease

25
prognosis
a resolving thyroiditis
26
what medications can cause drug induced thyroiditis
amiodarone | lithium
27
features of drug induced thyroiditis
pain
28
what is radiation induced thyroiditis
after radioactive iodine treatment for an overactive thyroid | the low levels of thyroid hormone after radioactive iodine is normally permanent
29
features of acute or infectious thyroiditis
triggered by bacterial infection pain in the throat, malaise symptoms of hyperthyroidism, symptoms of hypothyroidism antibiotics for infection
30
a 62y/o man presents with AF. He has not noticed, tremors, heat intolerance, weight loss. His thyroid gland is non-nodular, non-tender, and slightly enlarged. Serum TSH is low, T4 and T3 are raised. He is positive for thyroid peroxidase antibodies, and there is a low radioiodine uptake.
thyroid peroxidase antibodies (hashimotos) low radioiodine thyroiditis