Hyperthyroidism

Question 1

What is hyperthyroidism?

Answer 1

Over-production of thyroid hormone by thyroid gland

Question 2

What is primary hyperthyroidism?

Answer 2

• Due to thyroid pathology

- Thyroid itself behaves abnormally & produces excessive thyroid hormone

Question 3

What is secondary hyperthyroidism?

Answer 3

Condition where thyroid is producing excessive thyroid hormone as a result of overstimulation by thyroid stimulating hormone

Question 4

Pathology involved in secondary hyperthyroidism?

Answer 4

Hypothalamus or pituitary

Question 5

What is thyrotoxicosis?

Answer 5

Reefers to abnormal & excessive quantity of thyroid hormone

Question 6

What is Grave’s disease?

Answer 6

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

Question 7

Most common cause of hyperthyroidism?

Answer 7

Grave’s disease

Question 8

What is Toxic multinodular Goitre AKA?

Answer 8

Plummer’s disease

Question 9

What is toxic multinodular goitre?

Answer 9

Condition where nodules develop on thyroid gland that act independently of normal feedback system & continuously producing XSive thyroid hormone

Question 10

What does exophthalmos describe?

Answer 10

Term to describe bulging of eyeball out of socket caused by Grave’s disease

Question 11

What is pathology of exophthalmos?

Answer 11

Inflammation, swelling, hypertrophy of tissue behind eyeball that forces eyeball forward

Question 12

What is pretibial myxoedema?

Answer 12

Dermatological condition where there are deposits of mucin under skin on anterior aspect of leg (pretibial area)

Question 13

What is pretibial myxoedema specific to?

Answer 13

Grave’s

Question 14

Presnetation of hyperthyroidism?

Answer 14

Tremor 
Tachycardia 
Anxiety and irritability 
Sweating & heat intolerance 
Frequent loos stools 
Sexual dysfunction 
Wt loss

Question 15

Unique features of hyperthyroidism?

Answer 15

• Diffuse goitre (no nodules)
• Grave’s eye disease
• Bilateral exophthalmos
• Pretibial myxoedema

Question 16

Unique features of toxic multinodular goitre?

Answer 16

• Goitre with firm nodules
• Most patients are over 50
• Second most common cause of thyrotoxicosis

Question 17

What is thyroid storm?

Answer 17

• 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

Question 18

Management of hyperthyroidism?

Answer 18

Carbimazole= 1st line 
Propylthiouracil= 2nd line 
-Radioactive iodine 
-B Blockers 
-Surgery

Question 19

What is carbomazole?

Answer 19

1st line anti-thyroid drug

-Successful in treating Grave’s disease after 4-8 weeks

Question 20

What is propylthiouracil?

Answer 20

2nd line anti-thyroid

Small risk of severe hepatic reactions: hence Carbimazole=better

Question 21

What are beta blockers used for in treating hyperthyroidism?

Answer 21

Treat symptoms not underlying problem

-Used to block adrenalin related symptoms of hyperthyroidism