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30 Cards in this Set
- Front
- Back
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What's the most common cause of hypothyroidism in the US?
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Hashimoto's.
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Who gets hashimotos?
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Females.
10:1 |
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What kinds of antibodies are elevated in Hashimoto's?
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Anti-TPO
anti-Tg |
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What kinds of cells are abnormally elevated inside the thyroid in Hashimoto's Thyroiditis?
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CD8 T cells
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What other AI diseases are you at risk for if you have Hashimoto's Thyroiditis?
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Type 1 Diabetes
Addison's disease Pernicious anemia |
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What are the symptoms of hypothyroidism?
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Fatigue
Lethargy Weakness Cold intolerance Mentally slow Constipation Dry skin Infertility |
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What are some signs of hypothyroidism?
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Goiter (primary only)
Bradycardia Nonpitting edema Dry skin Delayed DTR relaxation HTN (diastolic) Slow speech, movements Hoarse |
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What's the difference between the goiters in Hashimoto's and Graves?
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Hashimoto's:
Firm, non-tdner May be irregular or asymmetric Graves: Always symmetric |
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What are the laboratory findings in hypothyroidism?
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Increased TSH
Decreased free T4 Decreased FT3 Anti-TPO and anti-Tg Abs (Hashimoto's) |
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What is the management for hypothyroidism?
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L-Thyroxine (T4) - most common!
Liothyronine (T3) |
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What are goals of therapy in hypothyroidism?
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Alleviate symptoms
Normalize TSH or free T4 |
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What's the half-life of T4? T3?
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T4: 7 days (it's bound more strongly to thyroxine binding globulin)
T3: 1 day |
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Who most commonly has thyroid nocules?
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Females.
5:1 |
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What percentage of thyroid nodules are benign?
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95%.
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What's on the differential for a thyroid nodule?
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What historical elements lend towards a thyroid nodule?
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Childhood irradiation
Age Gender Duration and Growth Local symptoms Hyper/hypothyroid Family history (MEN2) |
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In what sex are thyroid nodules more likely to be malignant?
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Men
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What are some especially worrisome local symptoms from thyroid nodules?
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Hoarseness
Problems with swallowing. |
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What are worrisome physical exam findings for a thyroid nodule?
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Large
Fixed Rocky Lymphadenopathy Vocal cord paralysis |
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What are the labs that you need to run when you have a thyroid nodule?
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TSH
Thyroid ultrasound Fine needle aspiration biopsy |
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What do you expect TSH levels to be in a thyroid nodule case?
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Low: suggests a hot nodule; benign hyperthyroidism
High: suggests Hashimoto's |
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What are some worrisome signs on neck US for thyroid nodules?
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Large: worrisome
Growing: worrisome Lots of blood flow: worrisome Irregular border Microcalcifications |
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What type of thyroid cancer is difficult to diagnose with a fine needle aspirate? Why?
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Follicular carcinoma vs. follicular adnoma
The carcinoma invades the capsule, which you can't tell via fine-needle aspirate. In order to diagnose this, you have to just take it out. SURGERY FTW! |
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What size of nodules do you biopsy?
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1-1.5 cm
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If someone is euthyroid and has a nodule, what kind of a nodule is it most likely?
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Cold: 90% are.
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What's the cancer risk from a cold nodule?
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5%
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What are the therapies for benign thyroid nodules?
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Generally nothing.
Sometimes T4 Occasionally surgery |
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What are the therapies for malignant thyroid nodules?
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Surgery (LOBECTOMY)
T4 to suppress TSH Radioiodine |
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What's the algorhythm for a solidtary thyroid nodule?
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What is Pemberton sign? What causes it?
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Facial flushing, increased stridor when the patient raises both arms above his/her head
Happens due to thoracic inlet obstruction to a retrosternal goiter |
