Hyperthyroidism

Question 1

In general, what is the cause of Hyperthyroidism?

Answer 1

Excessive of TH from Thyroid hyperfunction

Question 2

What causes Thyrotoxicosis?

Answer 2

Excessive Circulation of TH from any cause including thyroid hormone overdose

Question 3

What are 3 causes of primary hyperthyroidism?

Answer 3

• Graves’ Disease
• Toxic Multinodular Goiter (TMG)
• Toxic Adenoma

Question 4

What are 4 causes of Thyrotoxicosis w/o Hyperthyroidism?

Answer 4

• Subacute Thyroiditis
• Silent Thyroiditis
• Thyroid Destruction: Iodine, Amiodarone, Radiation, Infarcted Adenoma
• Ingestion of Excess Thyroid Hormone

Question 5

Secondary Hyperthyroidism is d/t what?

Answer 5

Excessive TRH or TSH From Hypothalamus or Pituitary

Question 6

What is a cause of Secondary Hyperthyroidism

Answer 6

• TSH Secreting Pituitary Adenoma

Question 7

What are the sxs of Hyperthyroidism?

SWEATING

Answer 7

• Sweating
• Weight loss
• Emotional/hyperactive
• Appetite increased/Afib in elderly
• Tremor/ tachycardia
• Intolerance of heat/ Irregular menstruation/ Irritability
• Nervousness
• GI problems (diarrhea)

Question 8

Excess TH are associated with increased risk of what?

Answer 8

• Osteoporosis

- Clubbing & Finger Swelling

Question 9

What are the diagnostic test for Hyperthyroidism?

Answer 9

↓TSH

↑TH (T4)

Question 10

What is the tx goal for Hyperthyroidism?

Answer 10

Goal: correct with minimal ASE

Question 11

What are the tx options for Hyperthyroidism?

Answer 11

• Antithyroid Med: PTU or Methimazole
• Radioactive iodine-131
• Thyroidectomy

Question 12

What are the tx options to help tx the tremors and palpitation in a pt with Hyperthyroidism?

Answer 12

Beta Blockers

Question 13

What are the tx options to help tx Afib in an elderly pt with Hyperthyroidism?

Answer 13

Anticoagulants

Question 14

What are the common sxs in an elderly pt with Hyperthyroidism?

Answer 14

• Apathy
• Wt Loss
• Unexplained Afib

Question 15

What is graves disease?

Answer 15

Autoimmune disorder: B cells produce Thyrotropin-Receptor Antibody (TSAb) that bind to TSH Receptors on the Surface of Thyroid Cells Triggering synthesis of Excess TH and growth of thyroid gland

Question 16

What is the MC disorder that causes Hyperthyroidism?

Answer 16

Graves Disease

Question 17

What are the clinical features of Graves Disease?

Answer 17

• Hyperthyroid symptoms
• Exophthalmos
• Dermatopathy
• Onycholysis

Question 18

What are some S/Sxs of Exophthalmos?

Answer 18

• Lid Retraction & Stare
• Dry Eyes & Blurred Vision
• Inflammatory Changes of EOM’s may Cause Diplopia

Question 19

What are some S/Sxs of Dermatopathy?

Answer 19

• Relatively rare
• A localized area of skin thickening and hyper-pigmentation over the tibia
• “Orange peel” texture

Question 20

What are some S/Sxs of Onycholysis?

Answer 20

• Painless detachment of the nail from the nail bed starting at the tip and/or sides

Question 21

What is diagnostic studies for Graves Disease?

Answer 21

↓TSH

↑TH (T4)

Question 22

What is the tx goal for Graves Disease?

Answer 22

GOAL: Correction With Minimal ASEs Including Hypothyroidism

Question 23

What is the tx for Graves Disease?

Answer 23

• All treatment for Hyperthyroidism

- Plus: artificial tears lubricant and lid taping at night.

Question 24

What is a goiter?

Answer 24

Enlarged thyroid gland

Question 25

What is a goiter caused by?

Answer 25

• Iodine deficiency
• Autoimmune disease
• Nodular diseases

Question 26

What is the MOA that causes a goiter?

Answer 26

• Biosynthesis defects and iodine deficiency associated with ↓efficiency of TH synthesis
• ↑ TSH
• Stimulates thyroid growth as a compensatory mechanism to overcome the blocked hormone synthesis

Question 27

Auscultation of Goiter May Identify what?

Answer 27

A bruit

Question 28

A bruit heard on auscultation of a goiter indicates what?

Answer 28

Indicates increased vascularity as in Hyperthyroidism

Question 29

A Goiter can occur in what 2 diseases?

Answer 29

• Graves disease

- Hashimotos Thyroiditis