Thyroiditis Flashcards

1
Q

Thyroiditis

A

Inflammation of the thyroid

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2
Q

Thyroiditis Aetiology

A
Hashimotos 
De Quervains (subacute) : Viral 
Post-partum 
Drug Induced (amiodarone, lithium) 
Radiation 
Acute Suppurative (bacterial)
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3
Q

Subacute Thyroiditis

A

Female> Male
Ages 25-50
May be triggered by viral infection

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4
Q

Subacute Thyroiditis Associations

A

may be associated with

  • neck tenderness
  • fever
  • typical viral symptom

Usually self-limiting over a few months

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5
Q

Amiodarone Effect on Thyroid

A

TFTs abnormal in up to 50% of patients

  • Inhibition of DIO1.
  • increased fT4
  • Decreased fT3
  • normal TSH

Hypothyroidism in 13%

hyperthyroidism in 2%

  • Type 1: Similar to Graves
  • Type 2: destructive thyroiditis
  • Mixed
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6
Q

Subclinical Thyroid Disease

A

Abnormal TSH with normal T3./T4

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7
Q

subclinical Hypothyroidism

A

Increased TSH
Risk of progression to overt hypothyroidism
Higher risk if strongly TPO antibody positive
Treatment advised if TSH>10
Always treat in pregnancy to maintain normal TSH

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8
Q

Subclinical Hyperthyroidism

A

Decreased TSH
Risk of progression to overt hyperthyroidism
Often seen in multi nodular goitre

Associations

  • OSteoporosis
  • AF

Treatment advised if TSH <0.1
(or if co-existing osteoporosis/ AF)

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9
Q

Non-thyroidal illness

A

Sick Euthyroid Syndrome

Commonly encountered in unwell, hospitalised patients
Refers to impact of recurrent illness on HPT axis

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10
Q

Sick Euthyroid Syndrome TSH

A

TSH typically surpassed initially then rises during recover

Avoid checking TFTs in unwell patients unless clinical suspicion of thyroid disease

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