Grave's Disease

Question 1

What is Grave’s disease?

Answer 1

Autoimmune HypErthyroidism

TSH receptor antibodies

Question 2

What symtpoms/signs does Grave’s present with?

Answer 2

Anexity
Weightloss
Heat intolerence
Exopthalmus
Clubbing
Gynecomastica
Diarrhoea
Sweating
Tremor
Lighter periods
Tachycardia
Swollen legs

Question 3

Investigation’s

Answer 3

TFT’s

FBC

Question 4

Management

Answer 4

Anti-thyroid drugs (not curative- only temporary)
Radioiodine
Surgery- thyroidectomy
Beta Blockers

Question 5

What anti-thyroid drugs are used to temporarily treat Grave’s/ other causes of hyperthyroidism?

Answer 5

Carbimazole
Propylthiouracil

can cause rash or agranulocytosis (low neutrophils)

Question 6

Other causes of hyperthroidism?

Answer 6

Toxic multinodular goitre (most common cause in the elderly)

de Quervain’s throiditis- younger patients (<50 years)

Question 7

How does de Quervain’s present?

Answer 7

Usually younger people (<50 years)

Viral trigger
Painful goitre
Fever
ESR increase

Have throidtoxicosis/ hyperthyroidism for 3-6 weeks
Then 3-6 months of hypothyroidism

Question 8

How is de Quervain’s treated?

Answer 8

Steroid

NSAIDS

Question 9

What is contraindication’s for RAdioiodine?

Answer 9

Elderly
Cardiac issues
Severe thyroid eye disease
Pregnant/ needs to be around children or pregnant person. Radiation coming off thyroid for 3-4 weeks after dose

Question 10

What is one of the anti-thyroid drugs used in Grave’s disease?

Answer 10

CArBImazole (remember CushlA BIng)