Hyperthyroidism Flashcards
Thyrotoxicosis
Abnormal + xs TH
Organ affected in 1ry hyperthyroidism
Thyroid gland
Aetiology of 2ry hyperthyroidism
Xs thyroid due to overstimulation by TSH
Graves causes 1ry hyperthyroidism due to antibodies formed against what receptor
TSH
Most common cause of hyperthyroidism
Graves
In toxic multi nodular goitre (plummer’s disease), nodules lead to hyperthyroidism through
- xs thyroid production
- independent of feedback mechanism
Exophthalmus is caused by
Graves
Histological finding in a tissue of pre-tibial myxoedema
Deposits of mucin in pre-tibial area
Presentation of pre-tibial myxoedema
- discoloured
- wacky
- oedematous
Cause of pretibial myxoedema
Reaction to TSH receptors antibodies (Graves)
Universal hyperthyroidism features
- anxiety & irritability
- fatigue
- sexual dysfunction
Temperature control in hyperthyroidism
Sweating & heat intolerance
HR in hyperthyroidism
Tachycardia
Weight changes in hyperthyroidism
Weight loss
Stool changes in hyperthyroidism
Loose (diarrhoea)
What causes the unique features of Graves
Reaction to TSH receptor antibodies
Goitre characteristic in Graves
Diffuse
Features of Graves (3)
- graves eye disease
- exophthalmus
- pretibila myxoedema
Goitre features in toxic multinodular goitre
Goitre + firm nodules
Patient ages in toxic multinodular goitre
> 50
2nd most common cause of thyrotoxicosis
TMG
Nodule in solitary toxic thyroid nodule
- single abnormal nodule
- release thyroid
Cause of solitary toxic thyroid nodule
Benign adenoma
Tx solitary toxic thyroid nodule
Surgical
Aetiology of De Quervain’s thyroiditis
- hyper then hypothyroidism
- -ve feedback —> TSH fall
Cause of De Quervain’s thyroiditis
Viral infection
Presentation of De Quervain’s thyroiditis
- hyperthyroidism
- viral symptoms
Thyroid storm
Presentation of hyperthyroidism
1st line management of hyperthyroidism
Carbimazole
What is given in the “block+replace” stage of managing hyperthyroidism if the “titration-block” stage causes hypothyroidism
Levothyroxine
Remission takes … with carbimazole
18 months
2nd line drug in treating hyperthyroidism which has serious hepatic side effects and can lead to death
Propylthiouracil
How long does remission take with iodine
16 months
Contraindications of radioactive iodine
Pregnancy
When to use beta blockers
Block adrenaline symptoms —> thyroid storm
Lifetime … is required if surgery is used to treat hyperthyroidism
Levothyroxine
Very important side effect of carbimazole which requires stopping the medication
Sore throat (BM suppression —> agranulocytosis)
what does nuclear scintigraphy reveal in toxic multinodular goitre
patchy uptake
what does nuclear scintigraphy reveal in grave’s
- diffuse enlargement of both lobes
- uniform uptake throughout
what does nuclear scintigraphy reveal in solitary adenoma
small focus of uptake
