Hyperthyroidism

Question 1

what are the diseases of hyperthyroidism ?

Answer 1

graves disease

toxic multi nodular goitre

AMIODARONE

Question 2

x

Answer 2

x

Question 3

Subacute (De Quervain’s) thyroiditis cause

Answer 3

thought to occur following viral infection and typically presents with hyperthyroidism

Question 4

features of subacute De Quervain’s) thyroiditis

Answer 4

hyperthyroidism

painful goitre

Question 5

diagnosis of subacute thyroiditis

Answer 5

globally reduced uptake on iodine-131 scan

raised ESR

Question 6

treatmnet of subacute thyroiditis ?

Answer 6

usually self-limiting - most patients do not require treatment

thyroid pain may respond to aspirin or other NSAIDs

in more severe cases steroids are used, particularly if hypothyroidism develops

Question 7

x

Answer 7

x

Question 8

x

Answer 8

x

Question 9

x

Answer 9

x

Question 10

x

Answer 10

x

Question 11

What is shown in scintography of toxic multinodular goitre?

Answer 11

Patchy uptake

Question 12

x

Answer 12

x

Question 13

x

Answer 13

x

Question 14

x

Answer 14

x

Question 15

rare but life-threatening complication of thyrotoxicosis is

Answer 15

Thyroid storm seen in established thyrotoxicosis: graves disease

Question 16

Precipitating events of thyroid storm ?

Answer 16

thyroid or non-thyroidal surgery
trauma
infection
acute iodine load e.g. CT contrast media

Question 17

clinical features of a thyroid storm ?

Answer 17

fever > 38.5ºC

tachycardia

confusion and agitation

nausea and vomiting

hypertension

heart failure

abnormal liver function test - jaundice may be seen clinically

Question 18

Mx of thyroid strom ?

Answer 18

(beta blockers, propylthiouracil and hydrocortisone)

beta-blockers: typically IV propranolol

anti-thyroid drugs: e.g. methimazole or propylthiouracil

dexamethasone - e.g. 4mg IV qds - blocks the conversion of T4 to T3

Lugol’s iodine