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Presentation
    Symptoms/Physical Exam
    Hypothyroidism
    Hyperthyroidism
    • Cold intolerance (↓ heat production)
    • Heat intolerance (↑ heat production)
    • Weight gain
    • ↓ appetite
    • Weight loss
    • ↑ appetite
    • Hypoactivityl
    • Lethargy
    • Fatigue
    • Weakness
    • Hyperactivity
    • Constipation
    • Diarrhea
    • ↓ reflexes
    • ↑ reflexes
    • Bradycardia
    • Tachycardia, palpitations, arrhythmias 
    • Dry, cool skin
    • Coarse, brittle hair
    • Warm, moist skin
    • Fine hair
    • Diastolic hypertension (Na/H
      2
      O
      retention)
    • Systolic hypertension
    • Myxedema (facial/periorbital)
    • Osteoporosis


Evaluation
 
    Labs
    Hypothyroidism
    Hyperthyroidism
    • ↑ TSH (best first test)  
    • ↓ TSH (best first test)
    • ↓ total T4
    • ↑ total T4
    • ↓ free T4
    • ↑ free T4
    • Hyper cholesterolemia (↓ LDL receptor synthesis)
    • Hypo cholesterolemia (↑ LDL receptor synthesis)
    • Elevated serum creatine kinase
     -

Treatment
 
    Treatment
    Hypothyroidism
    Hyperthyroidism
    • Levothyroxine
    • Thionamides
    • Ablative 131I therapy
 

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