hyperthyroidism

Question 1

most common cause of hyperthyroidism?

Answer 1

graves disease

Question 2

graves disease usually presents in ?

Answer 2

women aged 40-60

Question 3

what causes increased T3/T4?

Answer 3

production of antibodies that stimulate T3/4 production and release in the absence of TSH

Question 4

what are the autoantibodies seen in graves disease?

Answer 4

TRAB
Anti thyroid peroxidase
anti thyroglobulin

Question 5

what kind of goitre do you get?

Answer 5

smooth, symmetrical goitre

Question 6

specific signs of graves?

Answer 6

pretibial myxoedema

bilateral exopthalmos and opthalmoplegia

Question 7

who is nodular disease more commonly seen in ?

Answer 7

elderly patients

Question 8

what does nodular disease result in ?

Answer 8

toxic multinodular goitre

Question 9

what is a toxic multi nodular goitre?

Answer 9

multiple nodules that secrete thyroid hormone

Question 10

whats a toxic adenoma?

Answer 10

single nodule that secretes thyroid hormone and suppresses activity of the rest of the gland

Question 11

inflammatory cause of thyroiditis?

Answer 11

sub acute DeQuervains Thyroiditis

Question 12

sub acute de quervains is a transient inflammation of the thyroid gland. when would this occur?

Answer 12

after a viral illness

Question 13

what happens in DQT?

Answer 13

patients tend to cycle from hyper to hypo then back to normal

Question 14

treatment of DQT?

Answer 14

NSAIDS

Question 15

what is DQT associated with >

Answer 15

painful goitre, pyrexia and raised inflammatory markers

Question 16

GI symptoms?

Answer 16

diarrhoea

Question 17

motor?

Answer 17

tremor

Question 18

CVS?

Answer 18

palps

Question 19

GU

Answer 19

oligomennorhea +- infertility

Question 20

derm?

Answer 20

moist skin or lumps on shins

Question 21

mood?

Answer 21

anxiety, irritability, emotional liability, psychoss

Question 22

general?

Answer 22

heat intolerance, sweating, fatigue, weight loss, increased appetite, reduced conc, swelling in the neck

Question 23

ophthalmology?

Answer 23

gritty sensation in eye, eye discomfort, double vision, photophobia

Question 24

pre tibial myxoedema - hyper or hypo?

Answer 24

hyper - shin on grave

Question 25

ophthalmology signs

Answer 25

lid lag lid retraction chemosis (swelling of the conjunctive) exopthalmos - protrusion of the eye (GRAVES ONLY)

Question 26

diagnosis of hyperthyroidism?

Answer 26

TFTs, +- antibodies +- scintigraphy scan

Question 27

what does pre tibial myxoedema?

Answer 27

purple brown/ indurated plaques on shin

Question 28

High TSH and high T3/4?

Answer 28

secondary hyperthyroidism

Question 29

TSH and T3/4 level in primary hyper?

Answer 29

high T3/4, low TSH q

Question 30

scintigraphy results | High uptake in multiple locations.

Answer 30

multi nodular

Question 31

Single nodule of high uptake.

Answer 31

toxic adenoma

Question 32

Reduced uptake.

Answer 32

de quervains

Question 33

Diffuse, increased uptake.

Answer 33

graves

Question 34

symptom control management of hyperthyroid?

Answer 34

propranolol

Question 35

two anti thyroid medications

Answer 35

carbimazole and propylthiouracil

Question 36

which drug is favoured in pregnancy

Answer 36

PTU

Question 37

what is there a risk of in carbimazole ?

Answer 37

agranulocytosis

Question 38

what is used in radio ablation

Answer 38

radioactive iodine

Question 39

what are the risks of radio ablation?

Answer 39

thyroid storm in active disease | post treatment hypothyroidism

Question 40

contraindications to radio ablation

Answer 40

pregnancy, lactation

Question 41

what is a thyroidectomy?

Answer 41

o Surgical removal of part or all of the thyroid gland.

Question 42

risks of thyroidectomy?

Answer 42

recurrent laryngeal damage and hoarseness, hypothyroidism, hypoparathyroidism

Question 43

how does carbimazole work?

Answer 43

These drugs decrease the output of thyroid hormones from the thyroid gland by reducing the action of the peroxidase enzyme – thus preventing iodine from joining with tyrosine – which is what normally happens before the tyrosine is excreted from the cell and incorporated into a thyroglobulin molecule

Question 44

how long does it take for carbmiazole to work and what can be done in this time to

Answer 44

3-4 weeks

Question 45

what is given in this time to control symptoms ?

Answer 45

beta blockers