Thyroiditis

Question 1

Types of thyroidistis?

Answer 1

1. Autoimmune thyroidis
   a. Goiterous (hashimoto’s )
   b. Non goiterous (1ry myxedema)
2. Acute thyroiditis (eg pyogenic bacteria)
3. Subacute thyroiditis (de Quervain’s)
4. Chronic thyroiditis (TB is rare)
5. Collagen disease as Riedel’s disease

Question 2

What is the most common form of thyroiditis?

Answer 2

Hashimoto’s disease

Question 3

Antibodies of hashimoto D is ?

Answer 3

Antibodies to thyroglobulin & microsome and the antigen antibody reaction cause destruction fo the thyroid follicles

Question 4

Characteristic microscopic picture of hashimoto?

Answer 4

Acidophilic ASKANAZY cells + heavy lymphocytic infiltration + plasma cells

Question 5

Thyroid scan of hashimoto shows?

Answer 5

Low uptake cold nodules because its destroying the follicles . no hyperfunction

Question 6

Best investigation to DD with others and hashimoto?

Answer 6

FNABC… but difficult to differentiate between AI thyroiditis and lymphoma )

Question 7

Main line of ttt in hashimoto d?

Answer 7

Medical L thyroxin , cortisone indral

Question 8

Indication for surgery in hashimoto D?

Answer 8

1. Cosmotic disfigurement
2. Large goiter with pressure manifestations
3. Suspicion of malignancy (lymphoma)
   a. Rapid increase in size
   b. Ulceration
   c. Pain
   d. LN enlargement

Question 9

Complications of hashimoto thyroiditis?

Answer 9

1. Myxedema
2. Pressure
3. Lymphoma

Question 10

What is riedel’s thyroiditis?

Answer 10

As an AI disease or collagen disease where thyroid tissue replaced by cellular fibrous tissue which infiltrates (similar to malignancy)

Question 11

Ttt of riedel’s thyroiditis?

Answer 11

LAHEY’s operation (isthmectomy to relief pressure on trachea & to take biopsy)

Question 12

De quervain thyroiditis considered to be due to ?

Answer 12

Viral infection ( as a complication of MUMPS0 often following URTI
Ttt by oral prednisone for few weeks

Question 13

Investigations of de Quervain thyroiditis?

Answer 13

1. Increase ESR with normal or depressed leucocytis count
2. Sligh elevation of t4 with low iodine uptake fof the gland
3. Absent thyroid antibodies