Hyper thyroidism Flashcards
Epidemiology of Hyperthyroidism
Graves disease most common, 0.5 per 1000, much more common in women. Usually adults
1 in 1000 - in general
Aetiology of Hyperthyroidsim?
Graves disease - autoimmune stimulation of the thyroid (exopthalmos - pain, irritation, watery, ocular muscle weakness = double vision, pretibial myxodema)
goitre that may be painful, infiltrative dermopathy/pretibial myxedema - non-pitting itchy + red at first becoming brawny) more marked symptoms in general
Thyroiditis (caused by destruction of gland and release of stored hormone, NOT increased production) = Hyperthyroid -> hypothyroid
Drug induced thyroid hormone or excessive iodine intake
Non-autoimmune autosomal dominant
Multinodular goitre
Single autonomous ‘hot nodule
Secondary to pregnancy (hyperemesis gravidium, molar pregnancy)
Pituitary Tumours
Thyroid Tumours
Testicular Tumours
Ovarian Tumours
Natural History
may burn out and become hypothyroid
metabolic effects - secondary effects - weightloss
Bone pain
Symptoms
nervousness, palpitations, hyperactivity, excessive sweating, heat hypersensitivity, increased appetite, weight loss, insomnia, weakness, frequent bowel movements,
exercise tolerance decreased
ALSO menstruation light/infrequent
Physical signs
warm moist skin, tremor, tachycardia widened pulse pressure, palpitations, atrial fibrillation
eyes: stare, lid lag, eyelid retraction,
Complications
Thyroid storm (fever, marked weakness, muscle wasting, extreme emotional swings, confusion, psychosis, coma, nausea, vomiting, diarrhoea, hepatomegaly, jaundice, cardiovascular collapse and shock) = EMERGENCY
ALSO older people = apathetic hyperthyroid = depression/demential
CVS affects -
atrial fibrilation - congestive heart failure L ventricular thickening
loss of bone density
Prognosis
reversal of most symptoms with treatment depending on the cause
surgery or anti thyroid drugs
