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diagnosis endocrinology differential dermatology hypothyroid pruritus secondary systemic dequervains gynecomastia highthyroid interpretation management primary signs subacute symptoms tfts thyroiditis workup
Laboratory Evaluation of Patients for Thyroid Disease Hyperthyroidism: • Graves disease - TSH low; free T4
; in some cases, ... high; T4 normal ... free T4 normal; ... disease course #hypothyroid ... #hyperthyroid #
Abnormal Serum TSH - Differential Diagnosis Algorithm Increased TSH • Hypothyroidism • Sub-clinical Hypothyroidism • Recovery from
Abnormal Serum TSH ... Differential Diagnosis Algorithm ... • Hypothyroidism ... Recovery from Non-Thyroid ... #Hypothyroid #Hyperthyroid
Approach to Thyroid Function Tests in the Evaluation of Hyperthyroidism • Low TSH, Low normal T4
Approach to Thyroid ... normal T4 → Possibly ... • Low TSH, normal ... TSH, high T4 +/ ... #algorithm #diagnosis
Hyperthyroidism Overview Clinical Manifestation of Hyperthyroidism: • Fatigue • Weight loss • Heat intolerance • Depression, nervousness
goiter • Toxic diffuse ... T3 • ↑ Free T4 ... • Labs: - ↓ TSH ... Glucocorticoids: Reduce T4 ... #causes #diagnosis
Hyperthyroidism (low TSH, High T4/T3) - Diagnostic Algorithm Radioactive iodine scan – get if concern for nodular
Hyperthyroidism ... (low TSH, High T4 ... ) - Diagnostic Algorithm ... concern for nodular thyroid ... #Hyperthyroid #
Hyperthyroidism - Differential Diagnosis Algorithm High/Normal Radioiodine Uptake - Autoimmune Thyroid Disease: • Grave's
Hyperthyroidism ... Differential Diagnosis Algorithm ... High/Normal Radioiodine ... Struma Ovarii #Hyperthyroidism ... endocrinology #causes
Pruritus - Generalized Differential Diagnosis Algorithm - Systemic and Primary Causes == Primary Skin Lesions == Macules /
Pruritus - Generalized ... Systemic and Primary Causes ... failure/uremia TSH ... & T4: • Hypothyroidism ... #causes
Pruritus - No Primary Skin Lesion - Differential Diagnosis Algorithm Blood Glucose: • Diabetes Mellitus Liver Function Tests/Enzymes:
failure/uremia TSH ... & T4: • Hypothyroidism ... • Hyperthyroidism ... secondary #systemic #generalized ... #causes
Gynecomastia - Differential Diagnosis Algorithm No Testicular Mass on Ultrasound • Adrenal Neoplasm • Increased Extraglomerular Aromatase
Tumor Increased T4 ... , Decreased TSH ... • Hyperthyroidism ... T4 and TSH • ... #causes #endocrinology
Subacute Thyroiditis Also known as: de Quervain’s thyroiditis, granulomatous thyroiditis, or viral thyroiditis What? Postviral inflammatory process caused by
inflammatory process caused ... returns to normal ... (2) Hypothyroid ... phase: ↓ T4 and ... ↓ TSH levels (
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