PANCE REVIEW: Thyroiditis

So today's topic hits close to home because I was diagnosed with Hashimoto's thyroiditis this year after complaining of incredible fatigue. It was getting to the point that I was having difficulty getting through the day past 2p without napping. I was wiped out. So for today's PANCE review we will discuss Hashimoto's specifically - but you should also be familiar with the other forms such as subacute, post-partum, and infectious.

Hashimoto's Thyroiditis, Noteworthy Stuff Only
  • Most common form
  • Autoimmune or polyglandular syndrome
  • More common in women than me
  • Familial
  • Frequency increases with 1) iodine supp and 2) certain meds
  • Diffuse, enlarged, firm nodules (often asymmetric)
  • NOT painful*
  • Can see depression/chronic fatigue
  • Tests: serum antithyroid peroxidase and antithyroid globulin antibodies
  • Tx: lifelong thyroid hormone replacement (levothyroxine) for hypothyroidism, watchful waiting if goiter is present

*In contrast to subacute which is PAINFUL!

NOTE: Don't forget - for the PANCE... the single best screening test for thyroid dz is TSH!

Source: AAPA, PAEA Exam Review Book
Pic: http://www.nature.com/nm/journal/v10/n9/fig_tab/nm0904-895_F1.html

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