Hyperthyroidism Flashcards
describe primary and secondary hyperthyroidism
primary - thyroid pathology
secondary - pituitary or hypothalamus pathology, excessive stimulation by TSH
what are some general symptoms of hyperthyroidism
tachycardia
sweating
heat intolerance
weight loss
fatigue
frequent loose stools
sexual dysfuntion
describe what graves disease is
autoimmune condition where TSH receptor antibodies mimic TSH and activate TSH receptors
most common cause of hyperthyroidism
what are three signs of graves disease
exophthalmos
pre-tibial myxoedema
diffuse goitre
what is the second most common cause of hyperthyroidism
toxic multinodular goitre
multinodular goitre
generally occurs in >50 yrs
nodules act independently to produce excessive thyroid hormones
describe solitary toxic thyroid nodule
typically benign adenoma
independently releases thyroid hormones
managed by surgical excision
what is De Quervains Thyroiditis
recent viral infecton
fever, neck pain, tenderness, dysphagia and symptoms of hyperthyroidism
how would you manage De Quervains Thyroiditis
self limiting
could consider propanalol for hyperthyroidism symptoms and NSAIDs
what is first line management of hyperthyroidism
carbimazol
normal thyroid levels in 4-8 weeks
can keep maintenance dose or higher dose for a block and replace regime
second line treatment for hyperthyroidism
propylthiouracil
risk of severe/ life threatening hepatic reaction
what do those on radioactive iodine treatment need to be aware of
can take 6 months to achieve remission
risk of hypothyroidism
must not get pregnant for 6 months after treatment
avoid children and pregnant people during treatment
avoid close contact with anyone for few days after dose
what is thyrotoxicosis / thyroid storm
pyrexia, tachycardia and delirium
how is thyrotoxicosis managed
requires admission for monitoring and supportive treatment
fluids and b blockers
