Hyperthyroidism

Question 1

What is Hyperthyroidism?

Answer 1

Excess production of Thyroid Hormone

Question 2

General Signs of Hyperthyroidism?

Answer 2

Goitre, Heat intolerance, Tremor, Diarrhoea, Weight Loss/cachexia, Amenorrhea + Breast enlargement (women)

Question 3

Signs of Grave’s disease?

Answer 3

Grave’s: Acropachy, Ophthalmoplegia, Exophthalmos + Pre-tibial myxoedema.
Anti-TSH antibodies, generalized darkness (isotope scan)

Question 4

Investigation results for hyperthyroidism?

Answer 4

1) TFTs - LOW TSH (compensation), HIGH T4.
2) Auto-antibodies: Anti-TSH = Grave’s
3) Thyroid isotope scan/ultrasound if cause still unclear

Question 5

Signs of Toxic multinodular goitre?

Answer 5

Nodules secreting Thyroid hormone.

Concentrated in goitre, >1 dark spot on isotope scan.

Question 6

Signs of Toxic Adenoma?

Answer 6

Single secretory nodule. 1 dark spot (isotope scan).

Question 7

Basic management of Hyperthyroidism?

Answer 7

1) Carbimazole (titration) OR Block therapy (Carbimazole + levothyroxine). 12-18 months
2) Radioactive Iodine - not if breast feeding, hypothyroidism = side effect
3) Thyroidectomy - will become hypothyroid

Question 8

Red Flag signs of Thyroid Cancer

Answer 8

Rapid forming neck goitre, Hoarse Voice

Examination: Stony hard Goitre, fixed to other tissue + cervical lymphadenopathy.