Hyperthyroidism Flashcards
In general, what is the cause of Hyperthyroidism?
Excessive of TH from Thyroid hyperfunction
What causes Thyrotoxicosis?
Excessive Circulation of TH from any cause including thyroid hormone overdose
What are 3 causes of primary hyperthyroidism?
- Graves’ Disease
- Toxic Multinodular Goiter (TMG)
- Toxic Adenoma
What are 4 causes of Thyrotoxicosis w/o Hyperthyroidism?
- Subacute Thyroiditis
- Silent Thyroiditis
- Thyroid Destruction: Iodine, Amiodarone, Radiation, Infarcted Adenoma
- Ingestion of Excess Thyroid Hormone
Secondary Hyperthyroidism is d/t what?
Excessive TRH or TSH From Hypothalamus or Pituitary
What is a cause of Secondary Hyperthyroidism
- TSH Secreting Pituitary Adenoma
What are the sxs of Hyperthyroidism?
SWEATING
- Sweating
- Weight loss
- Emotional/hyperactive
- Appetite increased/Afib in elderly
- Tremor/ tachycardia
- Intolerance of heat/ Irregular menstruation/ Irritability
- Nervousness
- GI problems (diarrhea)
Excess TH are associated with increased risk of what?
- Osteoporosis
- Clubbing & Finger Swelling
What are the diagnostic test for Hyperthyroidism?
↓TSH
↑TH (T4)
What is the tx goal for Hyperthyroidism?
Goal: correct with minimal ASE
What are the tx options for Hyperthyroidism?
- Antithyroid Med: PTU or Methimazole
- Radioactive iodine-131
- Thyroidectomy
What are the tx options to help tx the tremors and palpitation in a pt with Hyperthyroidism?
Beta Blockers
What are the tx options to help tx Afib in an elderly pt with Hyperthyroidism?
Anticoagulants
What are the common sxs in an elderly pt with Hyperthyroidism?
- Apathy
- Wt Loss
- Unexplained Afib
What is graves disease?
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
What is the MC disorder that causes Hyperthyroidism?
Graves Disease
What are the clinical features of Graves Disease?
- Hyperthyroid symptoms
- Exophthalmos
- Dermatopathy
- Onycholysis
What are some S/Sxs of Exophthalmos?
- Lid Retraction & Stare
- Dry Eyes & Blurred Vision
- Inflammatory Changes of EOM’s may Cause Diplopia
What are some S/Sxs of Dermatopathy?
- Relatively rare
- A localized area of skin thickening and hyper-pigmentation over the tibia
- “Orange peel” texture
What are some S/Sxs of Onycholysis?
- Painless detachment of the nail from the nail bed starting at the tip and/or sides
What is diagnostic studies for Graves Disease?
↓TSH
↑TH (T4)
What is the tx goal for Graves Disease?
GOAL: Correction With Minimal ASEs Including Hypothyroidism
What is the tx for Graves Disease?
- All treatment for Hyperthyroidism
- Plus: artificial tears lubricant and lid taping at night.
What is a goiter?
Enlarged thyroid gland
What is a goiter caused by?
- Iodine deficiency
- Autoimmune disease
- Nodular diseases
What is the MOA that causes a goiter?
- 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
Auscultation of Goiter May Identify what?
A bruit
A bruit heard on auscultation of a goiter indicates what?
Indicates increased vascularity as in Hyperthyroidism
A Goiter can occur in what 2 diseases?
- Graves disease
- Hashimotos Thyroiditis
