Hyperthyroidism

Question 1

what is primary hyperthyroidism vs secondary hyperthyroidism

Answer 1

primary= pathology affecting the thyroid gland causing it to produce too much T3/T4
so blood test would show low TSH and high T3/4

secondary= pathology affecting the pituitary gland’s secretion of TSH
so blood test would show high TSH and high T3/4

Question 2

what results would you see in a blood test in primary and secondary hyperthyroidism

Answer 2

pimary= low TSH, high T3/4

secondary= high TSH, high T3/4

Question 3

what is Grave’s Disease

Answer 3

autoimmune condition

body produces antibodies that bind to TSH receptors in the thyroid gland causing chronic stimulation of the thyroid gland

Question 4

what can cause primary hyperthyroid

Answer 4

Graves disease (autoimmune stimulation of TSH receptors)

Toxic multi nodular goitre

thyroiditis

adenoma?

Question 5

how does hyperthyroid present

Answer 5

often a goitre
possibly thyroid bruit

feeling very warm
exophthalmos 
fine tremor
weight loss
palpitations
arrhythmia
insomnia

Question 6

how do you treat hyperthyroidism

Answer 6

propranolol helps symptomatic relief as it stops T4 being converted into active T3

Antithyroid medication- carbimazole

radioactive iodine if not in graves disease

thyroidectomy

Question 7

when do you do radioactive iodine treatment for hyperthyroid

Answer 7

for multi nodular toxic goitres and adenomas

not in graves disease

Question 8

when do you remove the thyroid gland (indication)

Answer 8

obstructive goitre
to stop recurrence

suspected cancer

Question 9

what are 2 common complications of thyroidectomies

Answer 9

hypoparathyroidism if they accidentally remove some of the parathyroid gland

laryngeal nerve damage

Question 10

how do you investigate hyperthyroidism

Answer 10

blood tests (thyroid function tests) to look for TSH and T3/T4

USS to look for masses