Name 8 common symptoms of hypothyroidism.
- Tiredness, lethargy
- Mental slowing and physical sluggishness
- Normal or decreased appetite with wt. increase
- Coarse & dry skin
- Intolerance of cold /hypothermia
- Depression, dementia
Name 5 causes of primary hypothyroidism.
- Autoimmune: esp. Hashimoto thyroiditis
- Postpartum thyroiditis: 10% of postpartum women, transient (2-4 mo)
- Subacute granulomatous thyroiditis: post-infections
- Drugs: e.g. amiodarone, interferon alpha, thalidomide, lithium, and stavudine.
- Iatrogenic: radiotherapy, thyroidectomy
- Iodine deficiency: worldwide, iodine deficiency is the most common cause of hypothyroidism
Name 5 causes for central hypothyroidism.
- Pituitary adenoma
- Tumors impinging on the hypothalamus
- History of brain irradiation
- Drugs (e.g., dopamine, lithium)
- Sheehan syndrome
- Genetic disorders
Outline 4 Ix for hypothyroidism.
- Autoimmune antibodies - anti-TPO, antimicrosomal antibodies)
- Ultrasound to detect nodules or infiltration
- FNAC to exclude malignancy
- TFT - TSH high, T4 low
Name 3 histopathological features in Hashimoto's disease glands.
- Diffuse lymphocyte and plasma cell infiltration
- Epithelial cells with abundant eosinophilic, granular cytoplasm = Hurthle cells
- Interstitial CT is increased
- Destruction of the function thyroid tissue
What are 2 other autoimmune diseases associated with Hashimoto's?
- Diabetes Type I
- Addison's disease
- B cell lymphomas
What is the cause for peripheral neuropathy in hypothyroidism?
Carpal tunnel syndrome with myxedema: mucopolysaccharide-rich edema accumulates in the skin, subcutaneous tissue, and visceral sites.