Chapter 57: Thyroid Gland- Benign Thyroid Disease

Question 1

What is the most common cause of hyperthyroidism?

Answer 1

Graves’ disease

Question 2

What is Graves’ disease?

Answer 2

Diffuse goiter with hyperthyroidism, exophthalmos, and pretibial myxedema

Question 3

What is the etiology?

Answer 3

Caused by circulating antibodies that stimulate TSH receptors on follicular cells of the thyroid

Question 4

What is the female-to-male ratio?

Answer 4

6:1

Question 5

What specific physical finding is associated with Graves’?

Answer 5

Exophthalmos

Question 6

How is the diagnosis made?

Answer 6

Increased T3, T4, and anti-TSH receptor antibodies, decreased TSH, global uptake of 131I radionuclide

Question 7

Name treatment option modalities for Graves’ disease

Answer 7

Medical blockade:

• iodide
• propranolol
• propylthiouracil (PTU)
• methimazole
• Lugol’s solution (potassium iodide)
• *Radioiodide ablation:** most popular therapy
• *Surgical resection** (bilateral subtotal thyroidectomy)

Question 8

What are the possible indications for surgical resection?

Answer 8

• Suspicious nodule
• if patient is noncompliant or refractory to medicines
• pregnant
• a child
• if patient refuses radioiodide therapy

Question 9

What is the major complication of radioiodide or surgery for Graves’
disease?

Answer 9

Hypothyroidism

Question 10

What does PTU stand for?

Answer 10

PropylThioUracil

Question 11

How does PTU work?

Answer 11

1. Inhibits incorporation of iodine into T4/T3 (by blocking peroxidase oxidation of iodide to iodine)
2. Inhibits peripheral conversion of T4 to T3

Question 12

How does methimazole work?

Answer 12

Inhibits incorporation of iodine into T4/T3 only (by blocking peroxidase oxidation of iodide to iodine)