Hyperthyroidism Flashcards

1
Q

WHat are the general effects of Hyperthyroidism?

A
Simialr to Caffeine...
HTN
Tachycardia
Diaphoresis
Oncholysis
Warmth
Hair Loss
Graves Dermopathy
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2
Q

What are the Eye Symptoms in Graves Disease?

A
Lid Lag
Lidretraction
Proptosis
Opthalmoplegia
Periorbital edema
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3
Q

What are the different causes of Hyperthyroidism?

A
Graves' disease
Autonomous nodules
Subacute thyroiditis
Iodine induced hyperthyroidism
TSH-producing pituitary adenoma
HCG-mediated
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4
Q

WHat is seen on labs in Hyperthyroidism?

A

Dec TSH +/- Inc FT4 or FT3
Ab testing- TSI
Radionucleide Scanning- thyroid uptake and scan

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5
Q

WHat are the features of Graves’ disease?

A
Most common cuse of Hyperthyroidism
More females
Ab to TSH receptors stimulate growth and homrone production
-TRAb, TSIg
-Family predisposition
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6
Q

WHat is seen on PE in Graves’ Disease

A
Goiter, diffusely enlarged
Hyperthyroidism, TSI
Uptake and scan
-not low
-scan homogenous
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7
Q

WHat is the general Tx of Graves’ disease?

A

Underlying issue is continuous stim. of the gland
Simp: Beta Blockers, steroids
Specific Tx: Slow down new hormone synth or remove source of Thyroid Horm.

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8
Q

What are the Antithyroid medications used in Graves’ disease?

A

MOA: inhib orgnification of iodine to iodotyrosine, and coupling
Adverse Effects: Hepatitis, agranulocytosis
Montior thyroid function, CBC, transaminases

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9
Q

How is the Thyroid Tx with Radioactive Ablation?

A

Iodine 131 give in single dose
Taken up by thyroid
-tissue destruction and ablation
Renders Pt Hypothyroid

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10
Q

What are the precautions with radiations in Thyroid Ablation?

A
Cant be preggo
No sexual activity
sleep alone
food prep
Flush twice, etc
Can transiently worsen hyperthyroid
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11
Q

What is the Pre-Op for Thyroidectomy Tx?

A
Antithyroid
SSKI 10 drops daily x1week
Decrease T4 and vacularity
Beta Blockers
Indications
-Personal
-Preggo
-large goiter
-Exposure to iodine
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12
Q

What are the diseases with Autonomously functioning nodules?

A

Single: hot nodule
Multiple: Toxic multinodular goiter
More common in older Pts >50yo

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13
Q

WHat is the Tx of Hot Nodules?

A

Unlike Graves’ toxic nodules will preferentially take up I131
Won’t spontaneously resolve
most Pts become euthyroid

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14
Q

What causes symptoms in Thyroiditis?

A

Inflammation of thyroid tissue, leakage of preformed hormone

not increased synthesis

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15
Q

What are causes of Thyroiditis?

A

Viral, radiation, iodine exposure, post-partum

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16
Q

What is seen on PET scan of Thyroiditis?

A

Low uptake of contrast

Patchy and faint

17
Q

What is the Tx of thyroiditis?

A

Supportive: NSAIDS

  • Prednisone
  • Beta Blockers
  • Antithyroids wont work too well
  • I131 won’t do anything…
18
Q

Who is more likely to get Iodine induced Hyperthyroid?

A

High Dose Iodine
AMIODARONE
Iodine can cause Thyroiditis
Inc Synth. Jod Basedow phenom

19
Q

What is the Tx of Amiodarone induce Hyperthyroidism?

A

Thyroid uptake and scan comes back low
Iodine binding sites SATURATED!!!
Antithyroid
I131 doesn’t work well

Surgery may be needed
Amiodarone often can’t be stopped for Cardiac reasons

20
Q

What form of iodine is used for Thyroid uptake scan? Ablation?

A

Iodine 123

Iodine 131

21
Q

What is seen in TSH producing Pituitary Adenoma?

A

Increased T4 with nonsuppressed or increased TSH
Hyperthyroidism
Goiter
Visual field defect

22
Q

What is the Tx of TSH producing Pit Adenoma?

A

Surgery

Octreotide

23
Q

What are the Dangers of Thyroid Storm?

A
Medical Emergency
Tachycardic
Hyperthermia
N/V, diarrhea
Mental status changes
24
Q

What is the Tx of Thyroid Storm?

A
Supportive with Fluid replacement, sedation, fluid, oxygen, cooling, Tx underlying cause
Tx ALGORITHM:
BB
Glucocorticoids: Dexamethasone
Antithyroids
Iodine
25
Q

What is Euthyroid Sick syndrome?

A

Hormones Fluctuate, more so in systemic/mental illness
Not due to Thyroid problems.
Will improve as systemic illness improves.