Hyperthyroid Conditions

Question 1

what is hyperthyroidism?

Answer 1

an overactive thyroid producing excess T3/4

Question 2

what is thyrotoxicosis?

Answer 2

state where the tissues are exposed to excess T3/4

Question 3

thyrotoxicosis causes

Answer 3

Grave’s
cancer
nodules
etc.

Question 4

presentation of hyperthyroidism

Answer 4

palpitations, AF, tremor
anxiety, irritability, insomnia
frequent, loose bowel movements
lighter and less frequent bleeding
increased BMR, weight loss
heat intolerance and sweating

Question 5

diagnostic techniques used in hyperthyroidism?

Answer 5

autoantibodies
TFTs
USS
scintigraphy

Question 6

management of hyperthyroidism

Answer 6

carbimazole
propylthiouracil (only first line in 1st trimester)
beta blockers for symptoms
eye disease management

Question 7

adverse of carbimazole and PTU

Answer 7

allergic reaction
liver problems
agranulocytosis

Question 8

what MUST you warn the patient about before prescribing carbimazole or PTU?

Answer 8

stop drug if fever, oral ulcer or oropharyngeal infection

Question 9

eye disease management options

Answer 9

topical lubricants

steroids

Question 10

what is Grave’s disease?

Answer 10

AI disorder that causes primary hyperthyroidism

Question 11

what age group is Grave’s disease common in?

Answer 11

women 20-50

Question 12

presentation of Grave’s disease

Answer 12

hyperthyroidism with diffuse enlargement of the thyroid
eye disease
pretibial myxoedema
thyroid acropachy (clubbing)
smooth velvety skin

Question 13

eye disease in Grave’s

Answer 13

exophthalmos
lid retraction
gritty eyes

Question 14

what worsens eye disease in Graves?

Answer 14

smoking

Question 15

appearance of pretibial myxoedema?

Answer 15

orange peel

Question 16

diagnosis of Grave’s disease

Answer 16

low TSH and high T3/4
TRAb
hypercalcaemia and high ALK (high bone turnover and OP)

Question 17

what is TRAb

Answer 17

TSH receptor antibody that mimics TSH found in Grave’s

Question 18

what is thyroid storm (crisis)

Answer 18

emergency condition with respiratory and cardiac collapse

Question 19

who is thyroid storm/crisis seen in?

Answer 19

hyperthyroid patients with acute infection/illness

Question 20

management of thyroid storm/crisis

Answer 20

iodine
steroids
PTU
beta blockers
fluids

Question 21

another name for toxic multinodular disease?

Answer 21

Plummer’s disease

Question 22

what is toxic multinodular disease?

Answer 22

nodules develop on the thyroid gland that act independently, constantly producing T3/4

Question 23

presentation of toxic multinodular disease

Answer 23

goitre with firm nodules

most patients >50

Question 24

what is solitary toxic thyroid nodule?

Answer 24

single nodule is acting alone to release excess thyroid hormone

these are usually benign adenomas

Question 25

what is De Quervain’s thyroiditis?

Answer 25

hyperthyroidism triggered by a viral infection

Question 26

presentation of De Quervain’s thyroiditis

Answer 26

fever
neck pain
dysphagia
hyperthyroidism

Question 27

management of De Quervain’s thyroiditis

Answer 27

self-limiting
NSAIDs
beta blockers if necessary