thyroid cases

Question 1

hyperthyroidism

Answer 1

symptoms: increased basal metabolic rate, weight loss, increased heat production, sweating, increased cardiac output, dyspnea, tremor, muscle weakness, exopthalmos, goiter

caused by:

• Graves disease: increased thyroid stimulating immunoglobulins.
• thyroid neoplasm
• excess TSH secretion
• exogenous T3 or T4

TSH levels:

• decreased if its an immunoglobulin issue and T3 and T4 rise will feedback on the anterior lobe
• increased if defect is in the anterior pituitary

Treatment:

• propylthiouracil- inhibits peroxidase enzyme and thyroid hormone synthesis
• Thyroidectomy
• 131I- destorys the thyroid
• beta adrenergic blocking

Question 2

hypothyroidism

Answer 2

symptoms: decreased basal metabolic rate, weight gain, decreased heat production, cold sensitivity, decreased cardiac output, hypoventialtion, lethargy, drooping eyelids, myxedema(skin issue, associated with hypothyroidism), growth and mental retardation, goiter

causes:
- thyroidosis: autoimmune or hashimoto thyroidosis
- surgery for hypothyroidism
- I- deficiency
- congential/cretinism
- decreased TRH or TSH

TSH level:

• increased by negative feedback if issue is primary defect of thyroid gland
• decreased if defect is in hypothalamus or anterior pituitary

treatment: thyroid hormone relacement