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Thyroid Disorders - Differential Diagnosis Algorithm Hypothyroidism: • Hasimoto’s • Radioactive Iodine • Hypopituitarism • Iodine
Thyroid Disorders ... • Radioactive Iodine ... Hypopituitarism • Iodine ... Amy Chung, MD, MSc ... @AmyChung #Thyroid
Thyroid Goiter on Physical Exam Mother and daughter both presenting with thyroid goiters caused by iodine deficiency.
Thyroid Goiter on ... presenting with thyroid ... goiters caused by iodine ... #PhysicalExam #iodine ... endocrinology #clinical
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 Laboratory Evaluation of Patients for Thyroid Disease Hyperthyroidism: • Graves disease - TSH low; free T4
of Patients for Thyroid ... increased radioactive iodine ... uptake; thyroid ... uptake; thyroid ... concentrations of TSH and thyroid
Amiodarone Thyroid Complications Amiodarone: - iodine-rich, similar structure to T4, with half life up to 100d
Amiodarone Thyroid ... Amiodarone: - iodine-rich ... pts w/ latent thyroid ... dz: iodine load ... Wolff-Chaikoff effect (iodine
Hyperthyroidism Overview Clinical Manifestation of Hyperthyroidism: • Fatigue • Weight loss • Heat intolerance • Depression, nervousness
Hyperthyroidism Overview Clinical ... Toxicosis • Iodine ... with radioactive iodine ... Thionamide - Iodine ... • Radioactive iodine
Differentiation of Causes of Hyperthyroidism According to Pattern of Radionucleotide Uptake Reduced uptake: • Thyroiditis • Exogenous
thyroxine • Iodine ... loading • Ectopic thyroid ... disease • Excess thyroid-stimulating ... #radioactive #iodine
Pharmaceutical Management of Hyperthyroidism / Thyroid Storm Beta-Blockers • Decreases sympathetic hyperactivity • Partially blocks peripheral conversion
Hyperthyroidism / Thyroid ... Blocks synthesis of thyroid ... Blocks synthesis of thyroid ... • Teratogenic Iodine ... release of stored thyroid
Approach to the Diagnosis of Hyperthyroidism - Differential Diagnosis and Workup Algorithm • Secondary Hyperthyroidism (↑↔TSH,
Radioactive Iodine ... disease • Low iodine ... goiter Radioactive Iodine ... • Thyroiditis, Iodine ... • Exogenous thyroid
Graves' Disease Treatment Thionamides (mainly methimazole) • Chance of remission in up to 2 years • No
2 years • No thyroid ... cost Radioactive Iodine
Approach to Thyroid Function Tests in the Evaluation of Hyperthyroidism • Low TSH, Low normal T4
Approach to Thyroid ... of pregnancy, critical ... symmetrically enlarged thyroid ... → Radioactive Iodine
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