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diagnosis differential endocrinology dermatology alopecia hairloss hypothyroid pruritus secondary systemic dequervains focal hashimotos hashitoxicosis hypothyroidism pathophysiology primary signs subacute symptoms
Laboratory Evaluation of Patients for Thyroid Disease Hyperthyroidism: • Graves disease - TSH low; free T4
Disease Hyperthyroidism ... high; in some cases ... iodine uptake Hypothyroidism ... disease course #hypothyroid ... #hyperthyroid #
Hyperthyroidism (low TSH, High T4/T3) - Diagnostic Algorithm Radioactive iodine scan – get if concern for nodular
Hyperthyroidism ... (low TSH, High T4 ... concern for nodular thyroid ... workup choices AND management ... #Hyperthyroid #
Hashitoxicosis ‘Leakage’ symptoms of active Hashimoto’s disease - Hashitoxicosis (Htx) can occur during the initial hyperthyroid stage in
during the initial hyperthyroid ... thyroiditis that causes ... hormone (hyperthyroidism ... enough of it (hypothyroidism ... Diffuse infiltration
Pruritus - Generalized Differential Diagnosis Algorithm - Systemic and Primary Causes == Primary Skin Lesions == Macules /
Pruritus - Generalized ... Differential Diagnosis Algorithm ... Systemic and Primary Causes ... /uremia TSH & T4 ... #causes
Hyperthyroidism Overview Clinical Manifestation of Hyperthyroidism: • Fatigue • Weight loss • Heat intolerance • Depression, nervousness
Hyperthyroidism ... goiter • Toxic diffuse ... T3 • ↑ Free T4 ... Glucocorticoids: Reduce T4 ... #causes #diagnosis
Hair Loss (Alopecia) - General (Diffuse and Focal) Differential Diagnosis Algorithm DIFFUSE Scarring - Irreversible-biopsy required • Lupus
Differential Diagnosis Algorithm ... Endocrine • Hypothyroidism ... • Hyperthyroidism ... contraceptives • Hyperthyroid ... #causes
Algorithmic Approach to Hypothyroidism - Differential Diagnosis and Management Framework Central Hypothyroidism (Secondary or tertiary) ↓TSH, ↓FT4
Algorithmic Approach ... Diagnosis and Management ... obtain TPOAb Euthyroid ... endocrinology #hypothyroid ... #Management
Pruritus - No Primary Skin Lesion - Differential Diagnosis Algorithm Blood Glucose: • Diabetes Mellitus Liver Function Tests/Enzymes:
/uremia TSH & T4 ... : • Hypothyroidism ... • Hyperthyroidism ... secondary #systemic #generalized ... #causes
Diffuse Hair Loss (Alopecia) - Differential Diagnosis Algorithm Scarring - Irreversible-biopsy required • Lupus erythematosus • Lichen
Diffuse Hair Loss ... Differential Diagnosis Algorithm ... • Hyperthyroidism ... contraceptives • Hyperthyroid ... #causes
Subacute Thyroiditis Also known as: de Quervain’s thyroiditis, granulomatous thyroiditis, or viral thyroiditis What? Postviral inflammatory process caused by
inflammatory process caused ... after onset Causes ... levels, ↓ TSH (2) Hypothyroid ... phase: ↓ T4 and ... #diagnosis #management
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