Hyperthyroidism Flashcards
Essentials of diagnosis for what issue?
(1) Sweating, weight loss, heat intolerance, menstrual irregularity, tachycardia, tremor,
stare (exophthalmos due to extraocular muscle edema)
(2) In Graves’ disease
–a) Goiter (often with bruit)
–b) Ophthalmopathy
–c) Thyroid stimulating immunoglobulins (activate TSH receptor in thyroid gland)
Hyperthyroidism
What is the most common cause of hyperthyroidism
Graves’ disease
Causes of hyperthyroidism
(a) ______ disease (most common)
(b) ______ thyroiditis may cause transient hyperthyroidism during initial phase and may occur postpartum (will eventually be hypothyroid)
(c) High serum human chorionic gonadotropin levels in first __ months of pregnancy, molar pregnancy, choriocarcinoma, and testicular malignancies may cause thyrotoxicosis
a) graves
b) Hashimoto’s
c) 4
What issue?
Signs:
(a) Fever
(b) Tachycardia
(c) Diaphoresis/sweating
(d) Tremors
(e) Disorientation/psychosis
(f) Goiter
(g) Exophthalmos
(h) Hyperreflexia
(i) Pretibial myxedema
Symptoms:
(a) Weight loss despite increased appetite
(b) Dysphagia or dyspnea 2° to goiter
(c) Rash/pruritus/hyperhidrosis
(d) Palpation/chest pain
(e) Diarrhea
(f) Myalgias and weakness
(g) Nervousness/anxiety
(h) Menstrual irregularities
(i) Heat intolerance
(j) Insomnia and fatigue
Hyperthyriodism
What issue?
(a) This disorder, rarely seen today, is an extreme form of thyrotoxicosis that may be triggered by stressful illness, thyroid surgery, or Radioactive iodine (RAI) administration.
(b) Manifested by marked delirium, severe tachycardia, vomiting, diarrhea, dehydration and, in many cases, very high fever.
(c) The mortality rate is high.
Thyroid storm
Treatment for hyperthyroidism
-Radioactive Iodine
-Propranolol (β blocker)
—–Generally used for symptomatic relief of tachycardia, tremors, diaphoresis, and anxiety until the hyperthyroidism is resolved.
What is the treatment of choice for active duty service members since thyroid suppressing medications (methimazole and propylthiouracil) generally preclude ongoing military service (not deployable).
Radioactive Iodine
Disposition of hyperthyroidism
MEDIVAC
Long term treatment HYPERTHYRIODISM:
(a) ________ is the most widely recommended permanent treatment of hyperthyroidism.
(b) Another permanent cure for hyperthyroidism is to _____________________.
——1) Both long term treatment options results in the patient developing hypothyroidism and lifelong need for ____________ is expected.
a) Radioactive iodine
b) surgically remove all or part of the thyroid gland
c) thyroid hormone replacement (levothyroxine)
Clinical Findings hyperthyroidism:
Thyroid
(a) _____ (often with a bruit) in Graves’ disease
(b) Moderately enlarged, tender_______ in subacute thyroiditis
a) Goiter
b) thyroid
Clinical Findings hyperthyroidism:
Eye
(a) Stare and _____
(b) ________ (chemosis, conjunctivitis, and mild proptosis) in 20- 40% of patients with Graves’ disease
(c) Diplopia may be due to coexistent _______
a) lid lag
b) Ophthalmopathy
c) myasthenia gravis
Clinical Findings hyperthyroidism:
Skin
(a) _____ skin
(b) ____ hair
(c) Onycholysis
(d) ________ in 3% of patients with Graves’ disease
a) Moist warm
b) fine
d) Dermopathy (myxedema)
Clinical Findings hyperthyroidism:
Heart
(a) Palpitations or angina pectoris
(b) Arrhythmias
—-1) Sinus tachycardia
—-2) Premature atrial contractions
—-3) Atrial fibrillation or atrial tachycardia
(c) ___________ due to thyrotoxicosis
(d) (Rarely) ______
c) Thyrotoxic cardiomyopathy
d) heart failure
Pt has these issues after Radioactive iodine (RAI) administration what would you suspect?
-marked delirium,
-severe tachycardia,
-vomiting,
-diarrhea,
-dehydration
-very high fever
Thyroid storm
