Hyperthyroidism Flashcards
What are the effects of T3/T4 on the CVS system?
Increases O2 consumption
Increases CO
Increases contractility
Increases cardiac mass
What is the effect of T3/T4 on the liver?
Increases protein synthesis
What is the effect of T3/T4 on the kidney?
Increases blood flow
What other effects does T3/T4 have?
Increases thermogenesis
What happens to the thyroid on swallowing?
Moves
What happens to the thyroid on tongue protrusion?
Nothing
What is primary hyperthyroidism?
Increased thyroid hormone production by the thyroid
What causes primary hyperthyroidism?
Graves disease
Toxic multinodular goitre
Thyroid adenoma
Subacute thyroiditis
What are the 3 features of Graves disease?
Graves eye disease
Pretibial myxoedema
Acropachy
What is Graves eye disease?
Exopthalmos - appearance of protruding eye
Proctosis - protruding eyes (seen from above)
Lid lag
What is the Von Graefe sign?
Lid lag
Why is there exopthalmos?
Inflammatory response of the muscles and fat pad behind the eye
What are the risks of Graves eye disease?
Corneal abrasion or ulceration
Due to reduced blinking
What is secondary hyperthyroidism?
Increased TSH causing increased thyroid hormones
What causes secondary hyperthyroidism?
Pituitary tumour
Ectopic thyroid tissue
Exogenous iodine/T3/T4
Amiodarone
What is the pneumonic for hyperthryoidism symptoms?
Thyroidism
What are the symptoms of hyperthyroidism?
Tremor Heart rate increased Yawning (fatigue) Restlessness Oligomenorrhea Intolerance to heat Diarrhoea Insomnia Sweating Muscle wasting / weight loss
What is De Quervains thyroiditis?
Self limiting swelling of the thyroid caused by a viral infection
What is the immediate management of hyperthyroidism?
B-blockers
To treat symptoms
What is the management of hyperthyroidism?
Carbimazole
Radioiodine
Thyroidectomy
What is a thyrotoxic storm?
Severe hyperthyroidism
What are the symptoms of a thyrotoxic storm?
Fever Agitation Confusion Tachycardia Thyroid bruit
How do you manage a thyrotoxic storm?
IV fluids
Propanolol
Carbimazole
Hydrocortisone