Verifed Ace the Test
Gynecomastia causes - ANSWER ✔✔-Aging
-Neonatal period, puberty (tall/overweight teenagers)
-Obesity
Hypothyroidism - ANSWER ✔✔-85% women
-May be due to failure or resection of the thyroid gland itself or deficiency
of pituitary TSH
Goiter - ANSWER ✔✔-May be present with thyroiditis, iodine
deficiency, genetic thyroid enzyme defects, drug goitrogens (lithium,
iodine, propylthiouracil or methimazole, sulfonamides, amiodarone,
,interferon-alpha, interferon-beta, interluekin-2, food goitrogens in iodine-
deficient areas
* often absent in autoimmune thyroiditis
Hypothyroidism labs - ANSWER ✔✔Serum TSH - high in primary and
low in secondary hypothyroidism
Elevated in Hashimoto thyoiditis
Hyperthyroidism labs - ANSWER ✔✔Serum TSH= suppressed
except in TSH-secreting pituitary tumor or pituitary hyperplasia (rare)
T3 uptake and scan= elevated, increased uptake
Subclinical hypothyroidism - ANSWER ✔✔Normal T4 with increased
TSH
may or may not have symptoms
Hypothyroid Treatment - ANSWER ✔✔-Synthetic levothyroxine
-Average does 1.6mcg/kg/day
-Repeat TSH in 4-6 week after initiation
-TSH levels should be between 0.4-2
, Hyperthyroidism (Thyrotoxicosis) - ANSWER ✔✔-Clinical
manifestations of elevated T4 or T3
-Most common form is Graves Disease
Grave's Disease - ANSWER ✔✔-Most common cause of
thyrotoxicosis
-Autoimmune disorder affecting the thyroid gland
-Increase in the synthesis & release of thyroid hormones
-More common in women
-Onset age 20-40
-Dietary iodine supplementation, chemotherapy can trigger
-Increased r/f systemic autoimmune dx including Sjogren, celiac,
pernicious anemia, Addison's, alopecia aerate, vitiligo, DM1,
hypoparathyriodism, myasthenia gravis, cardiomyopathy
Hyperthyroid examination findings - ANSWER ✔✔-Diffusely enlarged
thyroid
-Frequent asymmetric and often with bruit
-Subacute: moderately enlarged/tender, dysphagia, jaw/ear pain
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