HYPERTHYROXINEMIA ↓
inc binding affinity for T4 and/or T3
FAMILIAL DYSALUBMINEMIC
HYPERTHYROXENIEMIA
HYPOTHYROID
HASHIMOTO
-mc in iodine sufficient areas
T4
-Permanent (MC)
HYPETHYROIDISM
F- Factitia
E- Excess
LOW OR ABSENT RAIU
F- Functional
E- Ectopic
THYROTOXIC FACTITIA
IODINE EXCESS
ECTOPIC THYROID TISSUE
-Struma Ovarii
-Ovarian Teratoma
FUNCTIONAL METASTATIC FOLLICULAR CARCINOMA
THYROIDITIS HISTOPATH:
-patchy inflammatory infiltration
-disruption of thyroid follicles
-multinucleated giant cells (inside follicles)
-granuloma -> fibrosis
ACUTE THYROIDITIS
-Bacterial (SES)
-Staph
-Entero
-Strep
-Fungal (CCHAP)
-Candida
-Coccidiodes
-Histo
-Asperg
-Pneumocystis
-Amiodarone (subac/chr)
ANNUAL ff-up
-Amiodarone
Parasitic. (CES)
-Cysticercosis
-Echinococcosis
-Strongylodiasis
Trauma (palpate)
SICK EUTHYROID SYNDROME TSH, T4- Normal AVOID ROUTINE TEST OF THYROID during acute Ilness
NODULAR CLASSIFICATION
0: NO Goiter
1a: PALPABLE
1b. PALPABLE, VISIBLE (head TILT)
2. VISIBILE (Head NORMAL position)
3. VISIBLE AFAR
LEVOTHYROXINE
-start low
T4 suppression RARE EFFECTIVE
-risk: subclinical/overt THYROTOX
SURGERY: LOBECTOMY
(HR)
MICROfollicular
Hurthle
Trabecular
THYROID CA
TK INHIBITORS (Sorafenib)