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1. Endocrine > Hyperthyroidism > Flashcards

Hyperthyroidism Flashcards

1
Q

What is the most common cause of Hyperthyroidism?

A

Graves disease

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2
Q

What is thyrotoxicosis?

A

the state when tissues get exposed to excess thyroid hormone

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3
Q

What is the classical presentation of hyperthyroidism?

A 
exopthalmus - protrusion of eyes
sweaty
high heart rate
heat intolerance
weight loss
irritibility
anxiety
less bleeding --> ammenorrhea
increased appetite 
muscle weakness
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4
Q

At what age does Graves commonly present? male or female?

A

20-50years

female>male

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5
Q

What antibody is normally present in Graves?

A

anti TSH receptor antibody - TRAb

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6
Q

What are the clincial signs that are specific to Graves?

A

pretibial myoxedema
thyroid bruit - hyervascularity of thryoid
Graves eye disease - exopthalmus - TRAb driven, associated with smoking

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7
Q

What are the biological investigations for Hyperthyroidism?

A 
decreased TSH
increased free T3 and T4
hypercalcaemia 
increased Alk phos
decreased WCC
TRAb
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8
Q

What is a thyroid storm?

A

ABCDE EMERGENCY

severe hyperthyroidism characterised by resp and cardio collapse, acute illness, infection, hyperthermia

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9
Q

How is a thyroid storm treated?

A 
Lugols iodine
glucocorticoids
Proprylthuracil
beta blockers 
fluids
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10
Q

What is the 1st line treatment for hyperthyroidism?

A

carbimazole - not in pregnancy

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11
Q

What is the mechanism of these anti thyroid drugs - carbimazole?

A

inhibit TPO which blocks thyroid hormone synthesis

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12
Q

What is the mechanism of Proprylthuracil?

A

inhibits DIOI which decreases T4 –> T3 conversion

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13
Q

What are the side effects of carbimazole?

A

allergic rashes
cholestatic jaundice
fulimant hepatic failure
agranulocytosis

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14
Q

What other drugs can be used for the treatment of hyperthyroidism? What is their mechanims?

A

beta blockers - propanolol

  • reduces sympathetic nervous system
  • inhibits DIOI
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15
Q

What is the first choice medication for relapsed Graves and nodular thyroid disease?

A

radioiodine

  • contraindicated in pregnancy
  • increased risk of hypothyroidism
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16
Q

When would a thyroidectomy be indicated?

A

when radioiodine is contraindicated

17
Q

What is another cause of hyperthyroidism apart from Graves?

A

nodular thyroid disease

18
Q

How does nodular thyroid disease present?

A 
asymmetric goitre
TRAb antibody negative
older patients
thyroid will feel nodular 
high uptake on scintigraphy

1. Endocrine (32 decks)

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