Latest - (Latest / 1. ‘PTH and ‘ CA+ Answer: Hyperp...

Thyroid Disorders (PEARLS) (Smarty PANCE) (Latest /

• ‘PTH and ‘ CA+

Answer: Hyperparathyroidism

2. “PTH and “ CA+:

Answer Hypoparathyroidism

• A 62-year-old woman presents complaining of joint pain, polyuria, polydipsia, and

generalized fatigue. The woman reports a history of recurrent kidney stones and depression.Radiographs show osteopenia and subperiosteal resorption on the phalanges.

Answer: Hyperparathyroidism

• Tingling, tetany, trousseau's

Answer: Hypoparathyroidism

• “TSH and ‘ Free T4

Answer: Hyperthyroidism

• Weight gain, fatigue, edema

Answer: Hypothyroidism

7. ‘TSH and “ Free T4:

Answer Hypothyroidism

• Weight loss, anxiety, tachycardia

Answer: Hyperthyroidism

• Hoarse voice, cold nodule on thyroid uptake scan

Answer: Thyroid neoplastic disease

• Neck tenderness preceded by a viral illness (will likely be a URI) a few weeks earlier.

Answer: Thyroiditis

• ‘PTH usually caused by a PTH secreting parathyroid ADENOMA

Answer: Primary hyperparathyroidism

• Secondary hyperparathyroidism - Chronic kidney disease is the most common cause of

secondary hyperparathyroidism.Answer: ‘ PTH by a physiologic response to hypocalcemia or vitamin D deficiency.

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• Thyroid nodules larger than cm should be biopsied?

Answer: Lesions larger than 1 cm should be biopsied. Lesions with features suggestive of malignancy (Microcalcifications, hypoechogenicity, a solid nodule, irregular nodule margins, chaotic intranodular vasculature, and a nodule that is more tall than wide) and those in patients with risk factors for thyroid cancer should be biopsied, regardless of size. Smaller lesions and those with benign histology can be followed and reevaluated if they grow.

• Initial hyperthyroidism which may occur with Hashimoto's thyroiditis?

Answer: -Hashitoxicosis

• Which disorder causes osteoporosis, bone pain, renal calculi GI symptoms and psychosis?

Answer: Hyperparathyroidism

• Which type of thyroiditis has fever pain redness and neck mass?

Answer: Suppurative Thyroiditis - Most common cause staph or strep

• What is the preferred test to set initial dosing of thyroid replacement?

Answer: TSH

• What is the treatment for Hashimoto's thyroiditis?

Answer: Lifetime replacement of thyroxine (T4) (levothyroxine or liothyronine)

• What is the drug of choice to treat a pregnant/breast feeding patient with

hyperthyroidism?Answer: PTU in the first trimester then methimazole for rest of pregnancy (both are OK for nursing)

• What does a cold nodule on thyroid uptake scan likely represent?

Answer: Malignancy

• What is the most common treatment for primary hyperparathyroidism?

Answer: -Surgical removal

• Are renal calculi are more common with hypo or hyperparathyroidism?

Answer: - Hyperparathyroidism due to increased urinary excretion of calcium from the high serum calcium levels

• List the five hallmark signs and symptoms of hyperparathyroid disease.

Answer: -Osteoporosis - Renal calculi - Bone pain - GI symptoms - Depression/psychosis

• What happens to serum and urinary calcium in hyperparathyroidism?

Answer: - Increased PTH = increased Serum Ca++ and decreased Urine Ca++ initially but increased Urine Ca++ chronically

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