Hyperthyroidism Flashcards
What is hyperthyroidism?
Over-production of thyroid hormone by thyroid gland
What is primary hyperthyroidism?
- Due to thyroid pathology
- Thyroid itself behaves abnormally & produces excessive thyroid hormone
What is secondary hyperthyroidism?
Condition where thyroid is producing excessive thyroid hormone as a result of overstimulation by thyroid stimulating hormone
Pathology involved in secondary hyperthyroidism?
Hypothalamus or pituitary
What is thyrotoxicosis?
Reefers to abnormal & excessive quantity of thyroid hormone
What is Grave’s disease?
AI Condition
- TSH receptor causes primary hyperthyroidism
- TSH receptor antibodies are ABNORMAL Antibodies produced by immune system that mimic TSH & stimulate TSH receptors on thyroid
Most common cause of hyperthyroidism?
Grave’s disease
What is Toxic multinodular Goitre AKA?
Plummer’s disease
What is toxic multinodular goitre?
Condition where nodules develop on thyroid gland that act independently of normal feedback system & continuously producing XSive thyroid hormone
What does exophthalmos describe?
Term to describe bulging of eyeball out of socket caused by Grave’s disease
What is pathology of exophthalmos?
Inflammation, swelling, hypertrophy of tissue behind eyeball that forces eyeball forward
What is pretibial myxoedema?
Dermatological condition where there are deposits of mucin under skin on anterior aspect of leg (pretibial area)
What is pretibial myxoedema specific to?
Grave’s
Presnetation of hyperthyroidism?
Tremor Tachycardia Anxiety and irritability Sweating & heat intolerance Frequent loos stools Sexual dysfunction Wt loss
Unique features of hyperthyroidism?
- Diffuse goitre (no nodules)
- Grave’s eye disease
- Bilateral exophthalmos
- Pretibial myxoedema
Unique features of toxic multinodular goitre?
- Goitre with firm nodules
- Most patients are over 50
- Second most common cause of thyrotoxicosis
What is thyroid storm?
- Rare presentation of hyperthyroidism AKA thyrotoxic sclerosis
- More severe presentation of hyperthyroidism with pyrexia, tachycardia and delirium
- Treated same way as other presentations of thyrotoxicosis, may need supportive treatment with fluid resus, anti-arrhythmics and B Blockers
Management of hyperthyroidism?
Carbimazole= 1st line Propylthiouracil= 2nd line -Radioactive iodine -B Blockers -Surgery
What is carbomazole?
1st line anti-thyroid drug
-Successful in treating Grave’s disease after 4-8 weeks
What is propylthiouracil?
2nd line anti-thyroid
Small risk of severe hepatic reactions: hence Carbimazole=better
What are beta blockers used for in treating hyperthyroidism?
Treat symptoms not underlying problem
-Used to block adrenalin related symptoms of hyperthyroidism
