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THYROID TESTS

THYROID TESTS. WHO SHOULD BE TESTED FOR THYROID DYSFUNCTION?. THYROID TESTS. BIOCHEMICAL/HORMONAL TESTS DYNAMIC TESTS RADIONUCLEID TESTS IMMUNOLOGIC TESTS IMAGING METHABOLIC TESTS,PERIFERAL INDICES FNA. BIOCHEMICAL TESTS. TSH T4,T3 T3RU FREE T4 INDEX (FTI) FREE T4,FREE T3 Tg

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THYROID TESTS

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  1. THYROID TESTS

  2. WHO SHOULD BE TESTED FOR THYROID DYSFUNCTION?

  3. THYROID TESTS • BIOCHEMICAL/HORMONAL TESTS • DYNAMIC TESTS • RADIONUCLEID TESTS • IMMUNOLOGIC TESTS • IMAGING • METHABOLIC TESTS,PERIFERAL INDICES • FNA

  4. BIOCHEMICAL TESTS • TSH • T4,T3 • T3RU • FREE T4 INDEX (FTI) • FREE T4,FREE T3 • Tg • OTHERS • rT3,iodothyroins,Triac,Tetrac,compound W,Urine Iodine

  5. PHYSIOLOGIC CONTROL OF THYROID HORMONE PRODUCTION

  6. TSH •  TSH • Almost always = Thyroid hormones • Rarely central hyperthyroidism • Thyroid hormone resistance •  TSH • Central hypothyroidism • Thyrotoxicosis (clinical or subclinical) • SES

  7. The relationship between serum TSH and free T4 concentration is shown for normal subjects (N) and in the typical abnormalities of thyroid function: A, primary hypothyroidism ; B, central or pituitary-dependent hypothyroidism; C, thyrotoxicosis due to autonomy or abnormal stimulation of the gland; D, TSH-dependent thyrotoxicosis or thyroid hormone resistance. Note that linear changes in the concentration of T4 correspond to logarithmic changes in serum TSH.

  8. T3RU • It is an index of TBG • If TBG  T3RU  • If TBG  T3RU  • T3RU * TOTAL T4 = FREE T4 INDEX

  9. Euthyroid T4 TBG Resin

  10. Hyperthyroid T4 T3RU  TSH  TBG Resin

  11. Tg • Indications : • Suspicious thyrotoxicosis factitia • Follow up of thyroid malignancy

  12. RADIONUCLEID TESTS • RAIU • THYROID SCAN • Tc99 • I123 • I131

  13. This is what a thyroid scan looks like with graves disease

  14. MNG

  15. Large cold nodule

  16. IMMUNOLOGIC TESTS • Anti TPO • Anti Tg • Anti TSHR

  17. ULTRASOUND

  18. CT Scan

  19. Primary Hypothyroidism • Central Hypothyroidism

  20. FNA • Fine-needle aspiration (FNA) biopsy of the thyroid gland is now an established, accurate diagnostic test that is routinely used as the first step in the evaluation of nodular thyroid disease .

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