Hyperthyroidism Flashcards
Describe Graves’ disease
Autoimmune
Gland becomes smoothly enlarged and overreactive and causes hyperthyroidism
What is Graves’ disease caused by
Antibodies binding to the TSH receptor and the thyroid gland becomes overactive
This can lead to enlargement of the thyroid forming a goitre
How does an overactive thyroid gland present
Raised basal metabolic rate Raised temp. Increased heart rate Myopathy Mood swings Diarrhoea Increased appetite but weight loss Tremor of hands Palpitations Sore eyes, goitre
What is Plummer’s disease
Toxic nodular goitre
NOT autoimmune
Benign adenoma that is overactive at making thyroxine
(No pretibial myxoedema, no exophthalmos)
What are the effects of thyroxine on the sympathetic nervous system
Sensitises beta adrenoceptros to ambient levels of adrenaline and noradrenaline, causing more apparent sympathetic activation
Tachycardia, palpitations, tremor in hands, lid tag
What are the symptoms of hyperthyroidism
Weight loss despite increased appetite Breathlessness Palpitations, tachycardia Sweating Heat intolerance Diarrhoea Lid lag and other sympathetic features
What is a thyroid storm
Medical emergency (50% mortality if untreated) Blood results confirm hyperthyroidism
What are the signs and symptoms of a thyroid storm
Hyperpyrexia >41degrees Accelerated tachycardia/arrhythmia Cardiac failure Delirium/ frank psychosis Hepatocellular dysfunction; jaundice
What are the treatment options for a thyroid storm
Surgery (thyroidectomy)
Radioiodine
Drugs
What is viral (deQuervain’s) thyroiditis
Radioiodine uptake is zero
Stored thyroxine is released
Toxic with 0 uptake
Hypothyroid 4 weeks later then thyroxine stores are exhausted
How does viral thyroiditis infect
Virus attacks thyroid gland causing pain and tenderness
Thyroid stops making thyroxine and makes viruses isntead
No iodine uptake
What are the signs and symptoms of viral (deQuervain’s thyroiditis
Painful dysphagia
Hyperthyroidism
Pyrexia
Raised ESR
How does Graves’ disease cause exophthalmos
Other antibodies bind to muscles behind the eye which pushes the eye forwards and causes EXOPHTHALMOS (also known as proptosis)
How does Graves’ disease cause pretibial myxoedema
Other antibodies stimulate the growth of soft tissue on the shin and causes PRETIBIAL MYXOEDEMA (hypertrophy)
