Hyperthyroidism Flashcards
what is hyperthyroidism also known as?
thyrotoxicosis
what are the main causes of primary hyperthyroidism?
- Grave’s Disease
- Thyroid Adenoma, secreting thyroid hormones
How does Grave’s cause hyperthyroidism?
- autoimmune condition
- antibodies produced that bind mimic TSH and continually activate the thyroid gland
- hyperplasia and hyperactivity of gland seen
- Increased release of TH switches off TSH release from anterior pituitary so [TSH]plasma very low.
what is a cause of secondary hyperthyroidism?
pituitary adenoma secreting TSH
How does thyrotoxicosis occur without hyperthyroidism?
- destructive thyroiditis
- excessive thyroxine administration
what are symtpoms of hyperthyroidism?
- Increased metabolic rate and heat production –> weight loss/heat intolerance
- Increased protein catabolism –> muscle weakness/weight loss
- Altered nervous system function –> hyperreflexia / tremors / anxiety / irritability
- Elevated cardiovascular function. TH is permissive to epinephrine, b receptors –> increased HR/contractile force, palpitations, sweaty palms
How do you diagnose hyperthyrodism?
-Symtpoms
+
-TSH receptor antibodies
what are the options for the management of hyperthyroidism?
- medical
- radioiodine –> high dose ablative
what does the medical management of hyperthyroidism involve?
- Carbimazole
(propylthiouracil alternatively)
- titration regimen - start at high dose and reduce every couple of months
How does carbimazole work?
acts by inhibiting thyroid peroxidise and thereby the production of thyroid hormones. Propylthiouracil acts in a similar way through the same enzyme pathway
What are some adverse effects of Carbimazole?
- neutropenia - as it suppresses bone marrow
- GI disturbance
- rash and itch
what are signs of hyperthyroidism?
- thyroid eye problems:
- exophthalmos (proptosis)
- lid lag
- peri orbital swelling
- goitre
identify what condition the woman in this photo has
Grave’s
