Hyperthyroidism Flashcards
give the three most common causes of hyperthyroidism
grave’s disease
multinodular goitre
toxic adenoma
what type of antibodies are seen in Graves disease and in what proportion
TSH receptor antibodies (90%)
anti-TPO antibodies (10%)
give some signs of grave’s disease
eye disease
pretibial myxoedema
thyroid acropachy
what arrhythmia is relatively common in hyperthyroidism
AF
what investigations should you do if you suspect hyperthyroidism
TSH, T3, T4
Anti-TPO antibodies, anti TSH receptor antibodies
technectium scintigraphy
what causes graves disease
circulating IgG autoantibodies binding to and activating GPCRs which cause smooth muscle enlargment and increased thyroid production
what group is graves disease most commonly seen in
women aged 40-60 years
what can trigger graves disease
stress
infection
pregnancy
what happens to the bones in graves disease
increased bone turnover leading to osteoporosis
what group is most commonly affected by TMN
the elderly or patients from iodine deficient areas
what is subacute de Quervians thyroiditis
self-limiting, post-viral w/ painful goitre
low isotope uptake on scan
how should you manage hyperthyroidism
beta-blockers for rapid control of symptoms
anti-thyroid medication: carbimazole (or block-replace regimen which involves carbimazole + levothyroxine)
radioiodone
thyroidectomy
what nerve is at risk during a thyroidectomy
recurrent laryngeal
what is the severe side effect associated with carbimazole
agranulocytosis (really low neutrophils)
what is a thyroid storm
a rare but life threatening complication of thyrotoxicosis
may be hot, tachycardic, confused, agitated, AF
