Hyperthyroidism

Question 1

What is hyperthyroidism?

Answer 1

An endocrine disorder when the thyroid gland produces too much T3/T4

Question 2

Symptoms of hyperthyroidism?

Answer 2

General symptoms – tired, anxious, sweating
CVS – palpitations, heat intolerance
Abdo – weight loss, increased appetite
GU – oligomenorrhoea
CNS – tremor, eye problems, muscle weakness

Question 3

Investigations for hyperthyroidism?

Answer 3

Thyroid function tests
Thyroid antibodies - to exclude autoimmune aetiology
US thyroid and fine needle aspiration - cytology to differentiate malignant nodules
X-ray - to check for tracheal compression and retrograde extension
Thyroid scan - to distinguish between hot and cold nodules

Question 4

Signs of hyperthyroidism?

Answer 4

Smooth goitre
Tachycardia, AF
Lid retraction, lid lag 
Brisk reflexes
Proximal myopathy
Pre-tibial myxoedema
Acropachy

Question 5

Graves’ signs?

Answer 5

Triad of:

Opthalmopathy
Pre-tibial myxoedema
Acropachy

Question 6

Management of hyperthyroidism?

Answer 6

1. Medical:
   Carbimazole/propylthiouracil (for women of child bearing age)
   Beta blocker
2. Radioiodine
3. Surgery

Question 7

Primary hyperthyroidism on bloods?

Answer 7

Low TSH, high T4

Question 8

Secondary hyperthyroidism on bloods?

Answer 8

High TSH, high T4