Thyroid Disease Flashcards
What’s hyperthyroidism and its names and in which ages is common ?
*Increase thyroid hormones synthesis
Graves’ disease , toxic multimodal goiter (عقد على الغدة تكون سامة ) ، toxic Adenoma , metastatic thyroid cancer,
Young adults , women
What’s hyperthyroidism features ?
Increase metabolism (always Hungary )
Excessive energy = anxiety , no sleep , irritability
Loss of weight
Fragile fingers , hair loss , shaking hands ( high nerves sensitivity to epi and nor due to high thyroid hormones .
Worm , moist , high temp skin
Tachycardia, may arrthymia , cardiac diseases
Increase BP
NERVIOUSNESS
EXOPTHALMOUS ( due to increase fluid behind eyes making them protruded )
Hyperthyroidism and names ?
Hashimotos thyroditis ( autoimmune ) , iodine deficiency hypothyroidism ( espicially in mountains , due to water ) .
May hypothalamus TSH or pituitary TRH don’t secrete THIS HORMONES
may due to drugs ( carbimazole , methimazole , DTU , lithium )
What’s hypothyroidism in adults and children
Cretinism (children) : result from thyroid activity deficiency at birth ( dental eruption delay , overlange protruded tongue ) .
Adults : autoimmune ( may with sjorgeon syndrome cause its also autoimmune)
Which medication taken in hypothyroidism?
Thyroxin
Dental treatment of hyperthyroidism patient may affected by several factors what is this factors may don’t allow performance of treatment what is this factors ?
- Control nervousness
- If clinical signs are seen but the patient is not under treatment , refer to physician don’t work
- Avoid general anesthesia in patients with long standing thyrotoxicosis , particularly older patients
When to avoid epinephrine and vasoconstrictions ?
In untreated patient ( who didn’t do any surgery , no medications ….. )
Hyperthyroidism with cardiac excitability
There is no constructions regarding epinephrine in hypothyroidism patients ?
Yes , no constructions
Which medications to avoid in hypothermia patients and why ?
Sedatives like , diazepam , apoid analgesics , general anesthesia to avoid myxodema coma
Always local
Anemia and ischemic heart diseases can be associated with hypothyroidism ?
Yes and need modified treatment
Whupofh type suspectible to ischemic heart dosease ?
Hypothyroidism
Features of hypothy?
Cold intolerance
Weight gain
Slowed activity, thought
Dry skin , hair loss
Memory decline
Consitipation
Irregular heavy period
Xerostomia due to autoimmune may be with sjogreon syndrome
What’s the first question ?
Controlled or not ?
Means if T3 &T4 in normal range or not
To be normalized need 3 months with good treatment
Should not be high or low
If controlled , no restrictions deal as normal patient .
There is restrictions on timing or chair position ?
No
There is bleeding risk ?
No , only in PTU , methimamazol (antithyroid for hyper ) drugs taken , low platelets
There is anesthesia restrictions. ?
No , only if hyper don’t with epi or any vasoconstrictors or take beta blockers
Up to 2 but better without
Do we need antibiotic prophylaxis ?
No if controlled
Patient who are not controlled may develop during treatment ?
hypo / hyper crisis
Any elective please don’t work before referring , don’t with epi
Uregent , do rapid extraction , rapid incision ….
Hypo (myexodema coma) , bradycardia , shock , low BP , hypoglycemia
Hyper ( thyrotoxe crisis ) , any thing take us into strees , tachycardia , increase metabolism , sweat , tremor , high BP , coma
How to deal with emergency ?
Hypo = warm blanket
Hyper = cold blanket
For both IV Hydrocortisone 300 mg
Call ambulance
45 Y.O lady , presented to your clinic to undergo dental extraction she known to have hyperthyroidism currently TSH is normal .
Would you give her epinephrine and lidocaine ?
No restrictions freely , if she don’t take beta blockers give up to 2 carouses
