Hypothyroidism and Thyroid Cancer

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Notes from Doctors in Training
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Hypothyroidism and Thyroid Cancer
  1. Hypothyroidism
    1. Cold intolerance
      1. Weight gain
        1. Constipation
          1. Lowering of the voice
            1. Menorrhagia
              1. Slowed mental and physical function
                1. Dry skin with coarse, brittle hair
                  1. Reflexes showing slow return phase
                    1. Treatment
                      1. Levothyroxine: synthetic analog of thyroxine (T4)
                        1. Triiodothyronine (T3)
                      2. Cretinism
                        1. Iodine-deficient diet
                          1. Thyroid-related enzyme deficiency
                            1. Thyroid developmental defect
                              1. Failure of thyroid descent during development
                                1. Transfer of antithyroid antibodies from the mother with an autoimmune disease to the fetus
                                2. Hashimoto thyroiditis
                                  1. Hypothyroidism with painless goiter
                                    1. Dense infiltrate of lymphocytes into the thyroid
                                      1. Diagnosis
                                        1. Antithyroglobulin
                                          1. Antithyroid peroxidase antibodies
                                          2. 5:1 female predominance
                                            1. Increased incidence with age
                                              1. Associated with HLA-DR5 and HLA-B5
                                              2. Riedel's thyroiditis
                                                1. Chronic inflammation of thyroid -> fibrous tissue
                                                  1. Hypothyroid or euthyroid
                                                    1. Presentation
                                                      1. Fixed, hard, rock-like thyroid
                                                        1. Painless goiter
                                                        2. Histology
                                                          1. Macrophages
                                                            1. Eosinophils
                                                          2. Surgical complications
                                                            1. Parathyroid glands
                                                              1. Recurrent laryngeal nerve
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