Hyperthyroidism Flashcards
what are the diseases of hyperthyroidism ?
graves disease
toxic multi nodular goitre
AMIODARONE
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Subacute (De Quervain’s) thyroiditis cause
thought to occur following viral infection and typically presents with hyperthyroidism
features of subacute De Quervain’s) thyroiditis
hyperthyroidism
painful goitre
diagnosis of subacute thyroiditis
globally reduced uptake on iodine-131 scan
raised ESR
treatmnet of subacute thyroiditis ?
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
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What is shown in scintography of toxic multinodular goitre?
Patchy uptake
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rare but life-threatening complication of thyrotoxicosis is
Thyroid storm seen in established thyrotoxicosis: graves disease
Precipitating events of thyroid storm ?
thyroid or non-thyroidal surgery
trauma
infection
acute iodine load e.g. CT contrast media
clinical features of a thyroid storm ?
fever > 38.5ºC
tachycardia
confusion and agitation
nausea and vomiting
hypertension
heart failure
abnormal liver function test - jaundice may be seen clinically
Mx of thyroid strom ?
(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
