Updated: 9/17/2021

Hypothyroidism vs Hyperthyroidism

0%
Topic
Review Topic
0
0
N/A
N/A
Questions
6
0
0
0%
0%
Evidence
8
0
0
Topic
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

Please rate topic.

Average 5.0 of 6 Ratings

Questions (6)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK

(M1.EC.15.75) A 34-year-old female presents to her primary care physician complaining of fatigue. Over the last three months she has experienced decreased energy and gained 7 pounds. Review of systems is negative for symptoms of depression but is positive for constipation, myalgias, and cold intolerance. Physical exam is notable for delayed deep tendon reflex relaxation. Vital signs are as follows: T 37.1 C, HR 61, BP 132/88, RR 16, and SpO2 100%. Which of the following is the best initial screening test for this patient?

QID: 106821
1

Level of anti-thyroid peroxidase (TPO) antibodies

3%

(2/73)

2

Morning cortisol and plasma ACTH

3%

(2/73)

3

Serum Free T4

19%

(14/73)

4

Serum TSH

67%

(49/73)

5

Hemoglobin and hematocrit

3%

(2/73)

M 2 D

Select Answer to see Preferred Response

(M1.EC.13.69) A 58-year-old Caucasian female presents to her primary care physician with concerns about several recent health changes. The patient has recently gained weight and can't seem to exercise like she used to. She also notes that her thinking seems slow. Physical examination shows thickened, dry skin. Serum analysis confirms the physician's suspicions. Which of the following findings was most helpful in the diagnosis?

QID: 100370
1

High T4 and T3

5%

(3/55)

2

Low T4 and T3

31%

(17/55)

3

High TSH

36%

(20/55)

4

Hypercholesterolemia

4%

(2/55)

5

Low TSH

15%

(8/55)

M 2 E

Select Answer to see Preferred Response

(M1.EC.13.81) A 25-year-old female presents with recent muscle weakness, fatigue, and constipation. Physical examination reveals a bradycardic patient with cool, dry skin. Which of the following lab values would be most likely to be present with this patient's presentation?

QID: 100382
1

Elevated serum calcitonin

1%

(2/142)

2

Elevated serum CK

18%

(25/142)

3

Low serum TSH

36%

(51/142)

4

Activating TSH-receptor immunoglobulins

20%

(29/142)

5

Hypocalcemia

20%

(29/142)

M 2 E

Select Answer to see Preferred Response

Evidence (8)
VIDEOS & PODCASTS (1)
EXPERT COMMENTS (35)
Private Note