Hyperthyroidism

Question 1

Which cardiovascular drug can cause hyperthyroidism?

Answer 1

Amiodarone is a class IIIantiarrhythmicdrug that can causehyper-andhypothyroidism

Question 2

What is used to treat hyperthyroidism?

Answer 2

Beta blockers for symptomatic relief

Carbimazole however there is a risk of AGRANULOCYTOSIS and hepatotoxicity. Patients on this medication should ensure there is effective contraception during first and second trimester of pregnancy.

Question 3

What is the first line debit I’ve management of grave’s disease?

Answer 3

Anti-thyroid drug therapy with carbimazole for 12-18 months but this has 50% success

Question 4

What is 2nd line for grave’s?

Answer 4

Radioactive iodine ablation but this may becontraindicatedinGrave’s diseaseif the patient hasthyroid eye disease because it will exacerbate this

Question 5

What is thyroid eye disease?

Answer 5

Autoimmune destruction of periorbital muscle and orbital fat, causing diplopia, bulging eyes and vision loss, strongly assoicated with Grave’s

Question 6

What is thyroid gland pain associated with?

Answer 6

subacute granulomatous thyroiditis (De Quervain’s)

may improve with aspirin or other NSAIDs

Question 7

What is the management of toxic mutinodular goitre?

Answer 7

First-line:Radioactive iodine abalation
Second-line: Thyroidectomy (total in TMG/lobectomy in toxic adenoma))

Question 8

What is toxic mutinodual goitre?

Answer 8

Toxic multinodular goitre is a condition characterised by chronichyperthyroidismandmultinodular goitre which can be caused bychronic idodine deficiency or radiation to the neck

Question 9

What is a key compaction with hyperthyroidism/

Answer 9

Thyroid stormpresents withhyperthermia, tachycardia and hypertension

+ N&V, diarrhoea, altered mental state, arrhythmias

Hypertension has a wide pulse pressure and atrial fibrillation causing irrregularly irregular pulse

Question 10

A patient has a long-standingthyroid nodulethat moves superiorly whenever theystick out their tongue. What is the most likely diagnosis?

Answer 10

Thyroglobulin cyst that forms from a persistent congenital reminant of the thyroglossal duct

Question 11

What is a risk with thyroidectomy?

Answer 11

Wound haematoma with swelling in the neck 4-6 hours after surgery. This will abuse clear Inspiratory stridor and tense welling in the neck. It should be managed with removing the wound sutures