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What is the main parameter to be monitored for thyroid function?
Thyroid stimulating hormone (TSH)
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What diagnostic tool may be needed to distinguish different types of hyperthyroidism?
Radioactive Iodine Uptake (RAIU)
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Reference range for TSH-
Hyperthyroidism-
Hypothyroidism-
- 0.5 - 4.7
- Hyper - decreased
- Hypo - elevated
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Reference range for Total T4-
Hyperthyroidism-
Hypothyroidism-
- 4.5 - 10.9
- Hyper - elevated
- Hypo - decreased
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Reference range for free T4-
Hyperthyroidism-
Hypothyroidism-
- 0.8 - 2.7
- Hyper - elevated
- Hypo - decreased
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The following signs and symptoms are characteristic of what type of thyroid condition?
Nervousness, anxiety, heat intolerance, loss of weight and appetite, tachycardia at rest
Hyperthyroidism
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True or false?
An RAI scan showing increased RAI uptake would not be considered true hyperthyroidism.
False. Increased RAIU is diagnostic for true hyperthyroidism. Decreased RAIU is indicative of excess thyroid hormone not a consequence of thyroid gland hyperfunction
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What is the most common cause of hyperthyroidism?
Grave's disease
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Multinodular goiter most commonly effects whom?
Elderly individuals in whom independently function follicles have accumulated over many years and begin to produce more thyroid hormone than is needed.
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What are three general causes of decreased RAIU hyperthyroidism?
Subacute thyroiditis, painless thyroiditis, and medications eliciting hyperthyroidism
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What is the triphasic progression of subacute thyroiditis? Recovery time?
- Hyper --> hypo --> euthyroid
- Self-limiting with complete recovery in 2-6 months
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Treatment for subacute thyroiditis -
Symptomatic relief using beta blockers (for hyperthyroidistic sxs), aspirin for pain, and prednisone for inflammation
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Medications that may cause hyperthyroidism -
- 1. Excess exogenous thyroid hormone (thyrotoxicosis factitia)
- 2. Amiodarone
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What monitoring should take place in all patients who are about to initiate amiodarone therapy?
TSH measurement at baseline and every 6 months
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Reference range for Total T3-
Hyperthyroidism-
Hypothyroidism-
- 60 - 181 ng/dL
- Hyper - VERY ELEVATED
- Hypo - decreased
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What is the most common cause of hyperthyroidism?
- Grave's disease
- Thyroid stimulating antibodies that bind to and activate the thyrotropin receptor (acting like TSH).
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Grave's disease effects (men/women) more than (men/women).
Grave's disease effects women more than men.
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What type of hyperthyroidism acts as a "hot nodule" that takes up large amounts of radioactive iodine on an RAIU scan?
- Toxic adenoma.
- Amount of thyroid hormone produced is relative to size of mass.
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True/false?
In Grave's disease, the thyroid shows no signs of enlargement.
False, the gland is diffusely enlarged.
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What type of hyperthyroidism arises from multiple follicles that function independently?
Multinodular goiter.
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