Answers:
A patient with a high TSH, low T4 and normal T3 likely has ---? A patient with low TSH, low T4 and low T3 likely has---?
A) Subclinical hypothyroidism, Central hypothyroidism
B) Primary Hypothyroidism; Central hypothyroidism
C) Subclinical hypothyroidism; Primary hypothyroidism
D) T3 toxicosis, drug induced hypothyroidism
E) Hyperthyroidism; Sick Euthyroid
Primary hypothyroidism often presents with high TSH as the thyroid gland is not responsive in producing thyroid hormone. T3 may be low or normal in this situation as what T4 remains can continue to be converted to T3. Central hypothyroidism will have a low TSH due to pituitary failure which then results in low T3/4.
What is the rate of "incidentalomas" found on high resolution thyroid ultrasounds in the general population?
Estimates range from 19-67%.
MC Questions:
Thyroid stimulating immunoglobulin (TSI) is positive in 90% of patients with...
A) Hashimotos
B) de Quervains
C) Graves'
D) Hypothyroidism
E) None of the above
A) Subclinical hypothyroidism, Central hypothyroidism
B) Primary Hypothyroidism; Central hypothyroidism
C) Subclinical hypothyroidism; Primary hypothyroidism
D) T3 toxicosis, drug induced hypothyroidism
E) Hyperthyroidism; Sick Euthyroid
Primary hypothyroidism often presents with high TSH as the thyroid gland is not responsive in producing thyroid hormone. T3 may be low or normal in this situation as what T4 remains can continue to be converted to T3. Central hypothyroidism will have a low TSH due to pituitary failure which then results in low T3/4.
What is the rate of "incidentalomas" found on high resolution thyroid ultrasounds in the general population?
Estimates range from 19-67%.
MC Questions:
Thyroid stimulating immunoglobulin (TSI) is positive in 90% of patients with...
A) Hashimotos
B) de Quervains
C) Graves'
D) Hypothyroidism
E) None of the above
Free Response Question:
Describe the three maneuvers used when examining the thyroid gland.
Quick Facts:
Thyroid Nodules Clinical Findings
-nodules >1cm undergo further eval.
-1cm< eval if risk factors:
-suspicious US findings, adults younger than 30 or over 60, hx of irradiation, fam hx-recent growth, hoarseness, dysphagia or obstruction.-US may distinguish cyst from solid nodule
-suspicious findings = microcalcifications, irregular borders, increased blood flow.
-Once primary thyroid disease r/o w/ TFT do FNA.
-FNA indications: solitary nodule, multiple nodules that exist in multinodular goiter.
-If more than two nodules >1cm, fna the one with odd US findings.
-If all are <1cm fna dominant one.
-If subclinical/overt hypothyroid w/ nodules:
-99mTc pertechnetate or 123I prior to FNA.
-"Hot" nodules low risk, "cold" nodules more malignant and do FNA.
-Use 23-25 gauge-FNAs: 75% benign, 10% suspicious, 5% malignant, 15% nondiagnostic.
-Serous fluid = cystic lesion = less likely malignant.
-FNA nondiagnostic if no follicular epithelium or too much blood.-95% accurate.
No comments:
Post a Comment