Hyperthyroidism Flashcards
what is hyperthyroidism?
an overactive thyroid, where there is an overproduction of thyroid hormone
what is thyrotoxicosis?
a state of excess thyroid hormone exposure to tissues
what is a thyroid storm?
this is the severe end of the thyrotoxicosis spectrum where there is end organ damage
who is most likely to get hyperthyroidism?
more common in females
with Graves, it’s mostly in a younger population (30-50yrs) and ppl with a family history of autoimmune disease (celiac and T1DM)
what are 5 common etiologies for hyperthyroidism?
- Graves ➔ autoimmune
- toxic multinodular goiter ➔ iodine deficiency
- toxic adenoma
- factitious thyroiditis
- Drugs: amiodarone, lithium, anti-psychotics
how does Graves disease happen? (pathophys)
TSH receptor antibody ➔ stimulates the TSH receptor ➔ increases thyroid production of thyroid hormones + increases growth of the thyroid gland
What are some key characteristics of hyperthyroidism?
increased metabolism
- pretibial myxedema
- acropachy (soft tissue swelling of the hands and clubbing of the fingers)
- exophthalmos: eye protrusion
what is a potentially life-threatening cx of hyperthyroidism? and s/s
thyroid storm
tachycardia, increased GI motility, diaphoresis, anxiety, fever, and MOF
what ix would you order for hyperthyroidism?
- TSH and free T4/T3
- if everything elevated, then TSH producing pituitary adenoma
- if TSH is low, and T4/T3 is elevated, then hyperthyroidism and can ix further - autoimmune test for graves ➔ TRAb or do the radioiodine thyroid uptake and scan to determine etiology
- TRAb is out of pocket
what would you give to a severely symptomatic hyperthyroidism pt?
beta blockers
what treatment options are available for hyperthyroidism?
- medicinal - thionamid therapy (methimazole (MMI), and propylthiouracil (PTU))
- radioactive iodine therapy ➔ preferred for ppl high risk for surgery/have high-risk comorbidities
- thyroidectomy
