Thyrotoxicosis Flashcards

1
Q

Causes

A

Grave’s disease

Toxic nodular goitre

Acute phase of subacute thyroiditis

Acute phase of post-partum thyroiditis

Acute phase of Hashimoto’s thyroiditis

Amiodarone therapy

Contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Universal features of hyperthyroidism

A

Anxiety and irritability

Sweating and heat intolerance

Tachycardia and palpitations

Weight loss

Fatigue

Frequent loose stools

Sexual dysfunction

Oligomenorrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Grave’s disease

A

Autoimmune

TSH receptor antibodies are abnormal antibodies that mimic TSH

Most common cause of thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Toxic multinodular goitre

A

Plummer’s disease

Nodules act independently of normal feedback system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Unique features of Grave’s disease

A

Diffuse goitre (without nodules)

Graves eye disease

Bilateral exopthalmos

Pretibial myxoedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Unique features of toxic multinodular goitre

A

Goitre with firm nodules

Most patients over 50

Second most common cause of thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Solitary toxic thyroid nodule

A

Single abnormal thyroid nodule acting alone to release thyroid hormone

Usually benign adenomas

Treated with surgical removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

De Quervain’s thyroiditis

A

Presentation of viral infection with fever, neck pain and tenderness, dysphagia and hyperthyroidism

Hyperthyroid phase followed by hypothyroid phase as TSH falls due to negative feedback

Self-limiting condition

Supportive treatment with NSAIDs for pain/inflammation and beta-blockers for hyperthyroid symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thyroid storm

A

More severe presentation of hyperthyroidism with pyrexia, tachycardia and delirium

Requires admission for monitoring

May need fluid resuscitation, anti-arrhythmic medication and beta-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

First line management

A

Carbimazole 40mg and reduced gradually to maintain euthyroidism

Typically 12-18months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Carbimazole complication

A

Agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Radioactive iodine

A

Drink single dose of iodine and taken up by thyroid gland

Emitted radiation destroys proportion of thyroid cells

Reduction in functioning decreases thyroid hormone production

Remission can take 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Rules for radioactive iodine

A

Must not be pregnant/ can’t get pregnant within 6 months

Avoid close contact with children and pregnant women for 3 weeks

Limit contact with anyone for several days after dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Beta blockers

A

Used to block adrenaline related symptoms

Propanolol non-selectively blocks adrenergic activity

Particularly useful for patients with thyroid storm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly