Hyperthyroidism Flashcards

1
Q

Definition:

A

Disorder of thyroid hyperfunction that brings to the increase of the production/secretion of T3/T4

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2
Q

Corresponds to 80% of Hyperthyroidism cause:

A

Graves Disease

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3
Q

Doença de Graves (80%), Bócio Multinodular Tóxico, Adenoma Tóxico, Metástases funcionantes do carcinoma da tireoide e Excesso de iodo:

A

Primary Etiology

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4
Q

Anti-TSH receptor antibodies -> stimulates Thyroid -> T3 e T4 -> Goiter:

A

Graves Disease

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5
Q

Quadro Clinico:

A

Fáscies Basedowiana, queda de cabelos, nervosismo, intolerância ao calor, sudorese, insônia, fadiga, retração palpebral, oftalmopatia, bocio, taquicardia, hipertensão sistólica, Pele quente e úmida, tremor fino, perda ponderal, hiperdefecação e oligomenorreia, dermatopatia e agitação psicomotora

Dermatopatia infiltrativa: Mixedema pré-tibial

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6
Q

Exames Complementares:

A

HC, Função Hepática, TSH, T4 livre, *TRAb, anti-TPO, Anti-TG, US, Cintilografia e Captacao do Iodo Radioativo 24h

*Anticorpo antirreceptor do TSH

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7
Q

Tratamento:

A

*Antitireoidianos, Radioablacao com iodo radioativo e Tireoidectomia.

  • Propiltiouracil
  • Metimazol 10-30mg dose unica diaria
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8
Q

Indicações de Propiltiouracil:

A

Hipertireoidismo grave, Crise tireotóxica e no 1 trimestre da gestação

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9
Q

Contraindicações de Metimazol:

A

1 trimestre da gestação

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10
Q

Complicações:

A

Crise tiretoxica, Disfuncao cardiaca, Fibrilacao atrial e perda de massa ossea

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11
Q

Crise tireotoxica:

A

Taquicardia, Hipertermia, psicose, convulsoes, diarreia, vomitos e coma

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12
Q

Tratamento da Crise Tireotoxica:

A

Propiltiouracil 400mg 6/6h, *Propranolol 1-2mg EV 10/10min ate 10mg, Hidrocortisona 50mg EV 6/6h, Paracetamol, Diuretico, Digoxina e Oxigenio

*Diltiazem ou Verapamil

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13
Q

Syndrome caused by excess T3/T4:

A

Thyrotoxicosis

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14
Q

Age more affected:

A

20-50a

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15
Q

Male:Female ratio:

A

Most common in females 9:1

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16
Q

Adenoma hipofisário secretor de TSH, Síndromes de resistência ao hormônio tireoidiano, Tumores secretores de gonadotrofina coriônica e Tireotoxicose gestacional

A

Secondary Etiology

17
Q

Mola hidatiforme e Coriocarcinoma

Terciário:

Tireotoxicose s/ hipertir: Facticia, Tireoidite, tecido tireoidiano ectopico e Metástase do carcinoma folicular da tireoide

A

a

18
Q

Classic Graves Triad:

A

Diffuse Goiter, Ophthalmopathy and Infiltrative Dermopathy

19
Q

Osteopathy, Hypercalcemia, Hypercalciuria and + alkaline phosphatase (Pathophysiology):

A

Osteoclasts stimulation

20
Q

reação cruzada autoimune no tecido retro-ocular e periocular -> liberação de citocinas pró-inflamatórias -> Fibrose

A

Ophthalmopathy

21
Q

Why occurs autoimmune reaction causing Ophthalmopathy?

A

Smooth muscle cells and fibroblasts present antigens in the membrane similar to the TSH receptor

22
Q

Hiperemia conjuntival e palpebral, edema palpebral, quemose, exoftalmia ou paralisia de músculos extraoculares:

A

Oftalmopatia de Graves