hyperthyroidism and thyrotoxicosis Flashcards
What two conditions are associated with both hypo and hyperthyroidism?
Pernicious anaemia
Thymoma
What neuromuscular condition is often ass with thymoma?
Myasthenia Gravis
Symptoms of hyperthyroidsim
Heat intolerance
Amenorrhea
Tremor, sweat
Pretibial myxoedema
Exophthalmus
Causes of hyperthyroidism
Solitary toxic adenoma
Toxic nodular goitre
De Quervans
Treatment for Graves Disease
Carbimazole, propothyrorizide
Radioactive iodine
How can you visualise the metabolic activity of the thyroid?
Thyroid isotope scna (isotopes taken up by metabolically active tissues)
Ultrasound biopsy how done
Fine needle aspiration
What are the target tissue of T3/T4?
Heart
liver
Bone
CNS
Which form is more active and which from is more abundant of T3/4?
T3 - more active
T4 = more abundant
Metabolised in lvier
If lower T3/4 what happens to TSH, TRH?
Increases - negative feedback system
What does low TSH, high T3 and T4 mean?
Hyperthyroidism
Investigations for hyperthyroidism
Thyroid uotake scan
Thyroid antibodies
CNS symptoms hyperthyroidism
Agitation
Anxiety
Delirium
Psychosis
Stupor
Coma
General symptoms hyperthyroidism
CNS - anxiety, agitation etc
CVS - tacht, arrhytmia etc
Exophthalmos
Lid retraction
Thyroid acropathy
CVS symptoms hyperthyroidism
Tachycardia >140/min
Arrhytmia
Congestive cardiac failure
CV collapse
TfT levels in hyperthyroidism
Low TSH
High FT4 + FT3
Eye symtpoms of hyperthyroidism
Exophthalmos
Lid retraction
What does hyperthyroidism increase the risk of?
Diabetes
Dangerous complication of hyperthyroidism
Thyroid storm
Management of thyroid storm
Beta blocker/digocin, propanolol 60mg QDS
Thionamide - antithyroid medication PTU 200mg every 4 hours
Iodine solution - Loqols soluteion drops QDS
Steroids and bile acid eg hydrocortisone 100mg QDS + cholerstyramine 4mg QDS
What does thionamide do?
Blocks T3/T4 synthesis
What does iodiine solution do?
Blocks release of T3/T4
When treat subclincial hyperthyrodisim
Evidence for adverse effects on skeleton + the heart only in patinets with serum TSH levels < 0.1mU/L
Treatment be considered in patients TSH <0.1mU/L
Serum TSH 0.1-0.45 mU/L
What is Graves disease?
Anti-TSH receptor agonist antibodies bind to receptors stimulates excess T3/T4 production due to hyperplasia and unregulated production