Hyperthyroidism Flashcards

1
Q

hyperthyroidism

common?

A

affects ~2% of women (10 fold less in men)

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2
Q

Hyperthyroidism features

A

Weight loss, nervousness, heat intolerance, high cardiac output, hand tremors

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3
Q

Causes of hyperthyroidism

A

Primary hyperthyroidism due to hypersecreting thyroid tumour

Secondary due to excessive hypothalamic (TRH) or anterior pituitary (TSH) secretion

or, most commonly due to
Graves disease (50% of all cases)
Thyroid stimulating antibodies that mimic TSH

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4
Q

Symptoms/features of Graves disease

A

Often have protrusion of eyeballs (exopthalmos)

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5
Q

Hyperthyroidism Treatement

A

‘Ant-thyroid drugs’ that interfer with T3/T4 synthesis

Surgical removal or ressection of thyroid
Thyroid ablation using radioactive iodine

Will then require T4 replacement therapy for life

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6
Q

What are the adrenal Hormones

A

Secreted by adrenal medulla:
Adrenaline - in response to stress and exercise, increases heart rate

Secreted by adrenal cortex:
Cortisol - essential for adaptation to stress, mobilises glucose
anti-inflammatory actions (At high levels)

Aldosterone - maintains balance of Na/K in blood

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7
Q

H-P-A axis

What is the process of the secretion of cortisol?

A

1) Hypothalamus releases corticotropin releasing hormone (CRH) that acts on the anterior pituitary
2) This then releases corticotropin (ACTH) which acts on the adrenal medulla
3) The adrenal medulla then releases cortisol
4) High levels of cortisol inhibit release of corticotropin and corticotropin releasing hormone.

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8
Q

What is Addison’s disease

A

Deficiency of adrenocortical hormone - affects about 1- 50,000 people

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9
Q

Causes of Addison’s disease

A

~70% due to autoimmune destruction of adrenal cortex

Can be caused by infectious diseases (e.g TB)

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10
Q

Addison’s disease symptoms

A

Occurs in all age groups - both sexes equally

weight loss, muscle weakness, fatigue, low BP
often darkening of the skin and gums

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11
Q

Addison’s disease treatment

A

Replacement therapy with cortisol (and mineralocorticoid if needed)

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12
Q

What is Cushing’s syndrome?

A

Hypersecretion of cortisol

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13
Q

What causes Cushing’s syndrome?

A

Rapid pituitary ACTH secretion (=cushing’s disease)
Inappropriate ACTH secretion from tumour (pituitary or elsewhere)
Raised cortisol secretion from tumour in adrenal cortex

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14
Q

Cushing’s syndrome symptoms

A

Raised blood glucose levels => polyuria, polydipsia
Loss of muscle mass due to protein breakdown for gluconeogenesis
Deposition of new fat around abdoment, face, shouldners
Cardiovascular disease

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15
Q

Cushing’s syndrome treatment

A

Surgical removal of tumour
irradiation of tumour
inhibitors of steroid biosynthesis
(usually fatal within 5 years if untreated)

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