Hyperthyroid Conditions Flashcards
what is hyperthyroidism?
an overactive thyroid producing excess T3/4
what is thyrotoxicosis?
state where the tissues are exposed to excess T3/4
thyrotoxicosis causes
Grave’s
cancer
nodules
etc.
presentation of hyperthyroidism
palpitations, AF, tremor anxiety, irritability, insomnia frequent, loose bowel movements lighter and less frequent bleeding increased BMR, weight loss heat intolerance and sweating
diagnostic techniques used in hyperthyroidism?
autoantibodies
TFTs
USS
scintigraphy
management of hyperthyroidism
carbimazole
propylthiouracil (only first line in 1st trimester)
beta blockers for symptoms
eye disease management
adverse of carbimazole and PTU
allergic reaction
liver problems
agranulocytosis
what MUST you warn the patient about before prescribing carbimazole or PTU?
stop drug if fever, oral ulcer or oropharyngeal infection
eye disease management options
topical lubricants
steroids
what is Grave’s disease?
AI disorder that causes primary hyperthyroidism
what age group is Grave’s disease common in?
women 20-50
presentation of Grave’s disease
hyperthyroidism with diffuse enlargement of the thyroid eye disease pretibial myxoedema thyroid acropachy (clubbing) smooth velvety skin
eye disease in Grave’s
exophthalmos
lid retraction
gritty eyes
what worsens eye disease in Graves?
smoking
appearance of pretibial myxoedema?
orange peel
diagnosis of Grave’s disease
low TSH and high T3/4
TRAb
hypercalcaemia and high ALK (high bone turnover and OP)
what is TRAb
TSH receptor antibody that mimics TSH found in Grave’s
what is thyroid storm (crisis)
emergency condition with respiratory and cardiac collapse
who is thyroid storm/crisis seen in?
hyperthyroid patients with acute infection/illness
management of thyroid storm/crisis
iodine steroids PTU beta blockers fluids
another name for toxic multinodular disease?
Plummer’s disease
what is toxic multinodular disease?
nodules develop on the thyroid gland that act independently, constantly producing T3/4
presentation of toxic multinodular disease
goitre with firm nodules
most patients >50
what is solitary toxic thyroid nodule?
single nodule is acting alone to release excess thyroid hormone
these are usually benign adenomas
what is De Quervain’s thyroiditis?
hyperthyroidism triggered by a viral infection
presentation of De Quervain’s thyroiditis
fever
neck pain
dysphagia
hyperthyroidism
management of De Quervain’s thyroiditis
self-limiting
NSAIDs
beta blockers if necessary
