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ENDOCRINOLOGY > GRAVE'S DISEASE > Flashcards

GRAVE'S DISEASE Flashcards

1
Q

What is Graves’ Disease?

A

an autoimmune disorder which cause thyroid to overproduce thyroxine

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2
Q

What is the cause of Grave’s Disease?

A

speculating IgG autoantibodies stimulating TSH-receptor causing increase thyroxine production and causing hyperplasia

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3
Q

What is the symptoms of Grave’s Disease?

A

Diarrhoea

Weight loss

Increased Appetite

Oligomenorrhoea

Sweat and heat intolerance

Palpitations

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4
Q

What are the Signs of Grave’s Disease?

A

Arrhythmia and Tachycardia

Warm, Velvety and moist hands

Palmar Erythema

Exophthalmos

Conjunctival Oedema

Lid Lag

Pretibial Myxoedema

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5
Q

What are the Risk Factors of Grace’s Disease?

A

Family History

Female Sex

Stress

Age (<40)

Other autoimmune disorders (T1DM, Rheumatoid Arthritis)

Tobacco use

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6
Q

What would be your top differentials to Grave’s Disease?

A

TSH PRODUCING PITUITARY ADENOMA

TOXIC NODULAR GOITRE

THYROIDITIS

GESTATIONAL HYPERTHYROIDISM

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7
Q

Which blood test would you do for Grave’s Disease?

A

TSH: low

SERUM T3/4: high

TRAb: Positive

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8
Q

What imaging would you request for Grave’s Disease?

A

RADIOACTIVE IODINE RE-UPTAKE: elevated

THYROID ULTRASOUND: enlarged thyroid

CT SCAN: muscle thickening; done to excludes other causes

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9
Q

What are the treatment options of grave’s disease?

A

TITRATION: carbimazole (antithyroid)

BLOCK-REPLACE: Carbimazole + Levothyroxine

BETA-BLOCKER: Propranolol

RADIOACTIVE IODINE: oral beta/gamma emitter (destroy overactive thyroid cells)

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10
Q

How long is Carbimazole used for?

A

6-24months

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11
Q

How long is the Block-Replace used for?

A

12-18month

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12
Q

How long should Radioactive Iodine be used for?

A

6-18weeks

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13
Q

What are the side effects of the treatment?

A

Agranulocytosis (neutrophils stop forming) leading to sepsis - stop Carbimazole

Worsen Angina or Precipitate myocardial infarction - due to Levothyroxine

Worsened symptoms of Opthalmopathy - due to Radioactive Iodine

Joint Pain

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14
Q

Why is Beta Blocker used in the treatment of Grave’s Disease?

A

To quickly treat tachycardia, tremor, anxiety, heat intolerance, sweating, diarrhoea, and muscle weakness

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15
Q

How would you treat Opthalmopathy in Grave’s Disease?

A

Prednisone (corticosteroids) - reduce swelling

Prisms glasses - reduce double vision

Orbital Decompression Surgery - removal of bone between eye socket and sinuses

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16
Q

What are the complications of hyperthyroidism?

A

Pregnancy Issue e.g. Preeclampsia

Heart Disorders e.g. heart failure

Thyroid Storm - sudden accelerated hyperthyroidism

Osteoporosis

Corneal Ulceration

ENDOCRINOLOGY (7 decks)

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