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#Phase 2.1: GI > Hyperthyroidism > Flashcards

Hyperthyroidism Flashcards

1
Q

What is Hyperthyroidism?

A

The overprod of thyroid hormone by Thyroid gland

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2
Q

What is Thyrotoxicosis?

A

Acc having too much thyroid hormone in the body

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3
Q

What is Primary vs Secondary Hyperthyroidism?

A

Primary: problem in thyroid gland

Secondary: overstimulation by Thyroid Stimulating Hormone (TSH). Problem in Hyp / Pit

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4
Q

What is Grave’s? (3 things)

A
  1. AI condition
  2. Immune system makes fake TSH antibodies --> overstimulate TSH receptors on Thyroid Gland –> Primary Hyperthyroidism
  3. Most common cause of hyperthyroidism
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5
Q

What is the HPA Axis for Thyroid Hormones?

A
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6
Q

What are the Risk Factors for Hyperthyroidism? (3 things)

A
  1. Female
  2. Smoking
  3. FHx (Grave’s)
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7
Q

What are the causes of Hyperthyroidism? (5 things)

A
  1. Grave’s (most common)
  2. Toxic Multinodular Goitre (2nd most common)
  3. Pituitary resistance to Thyroid hormone
  4. TSH-secreting Pituitary Adenoma
  5. Solitary toxic thyroid nodule (benign adenoma)
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8
Q

What are the CF of Hyperthyroidism? (8 things)

A
  1. Sweating
  2. Weight loss
  3. Emotional liability
  4. Appetite increased / Anxiety
  5. Tachycardia / Tremor
  6. Intolerance to heat / Irregular mentruation
  7. Nervousness
  8. Goitre / Galoot (diarrhoea)

SWEATING

Hyperthyroidism, everything up up

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9
Q

What are the unique CF of Grave’s? (3 things)

A
  1. Exophthalmos (bulging eyes)
  2. Goitre (without nodules)
  3. Pre-tibial Myxoedema (non-pitting oedema on shins)
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10
Q

What investigations should you do for sus Hyperthyroidism? (5 + 2 things)

A
  1. TSH levels (LOW
  2. T3 + T4 levels (HIGH)
  3. FBC (Normocytic anaemia, aka low RBC of normal size)
  4. Neutropenia (low WCC) (in Grave’s)
  5. Antibodies (high in Grave’s)

Imaging (do if diagnosis still unclear)

  1. RAIU (Radioactive iodine uptake)
  2. Thyroid Doppler US
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11
Q

What antibodies will you see in Grave’s?

A

Thyrotropin receptor antibodies (TRAb)

in particular: Thyroid-Stimulating Immunoglobulins

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12
Q

What will a Radioactive iodine uptake (RAIU) scan show in Hyperthyroidism?

A

High iodine uptake = confirms Hyperthyroidism

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13
Q

When should you do a Thyroid Doppler US instead of Radioactive iodine uptake (RAIU) scan?

A

Pregnancy

RAIU contraindicated in pregnancy

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14
Q

What will a Thyroid Doppler US show in Hyperthyroidism? (3 things)

A
  1. Diffuse enlargement
  2. Solitary / multiple nodules
  3. Increased blood flow in gland
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15
Q

What are the management options for Hyperthyroidism? (4 things)

A
  1. Anti-thyroid meds
  2. Beta blockers
  3. Radioactive Iodine
  4. Surgery: Thyroidectomy
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16
Q

What are the 2 strategies for Anti-Thyroid medications?

A
  1. Titration
  2. Block + Replace
17
Q

What is the “Titration” strategy of Anti-Thyroid medication of Hyperthyroidism?

A

Carefully titrating Anti-Thyroid meds to reach perfect levels of Thyroid hormones

18
Q

What is the “Block + Replace” strategy of Anti-Thyroid medication of Hyperthyroidism? (2 things)

A
  1. Block: Big dose of Anti-Thyroid meds to completely block all Thyroid hormone production
  2. Replace: Giving Levothyroxine as replacement for Thyroid hormones (titrated to effect)
19
Q

What is the FIRST LINE Anti-Thyroid medication for Hyperthyroidism?

A

Carbimazole

20
Q

What is the SECOND LINE Anti-Thyroid medication for Hyperthyroidism?

Why is it SECOND LINE?

A

Propylthiouracil

2nd line bc risk of:

Severe hepatic reaction –> death

21
Q

What is the use of Beta blockers in Hyperthyroidism?

A

To control adrenalin related symptoms of hyperthyroidism

22
Q

What is the best Beta blocker for Hyperthyroidism?

Why?

A

Propranolol

Bc is NON-selective Beta blocker

So works everywhere not jus heart

23
Q

How does Radioactive Iodine work to manage Hyperthyroidism? (4 things)

A
  1. Pt drinks single dose of Radioactive Iodine
  2. Taken up by Thyroid gland
  3. Radiation destroys some of the Thyroid cells
  4. Reduction in functioning cells –> less Thyroid hormone production
24
Q

What is a drawback of Radioactive Iodine / Thyroidectomy treatment for Hyperthyroidism?

A

Can leave pt Hypothyroid afterwards

–> Req Levothyroxine replacement therapy forever

25
Q

What are the strict rules of Radioactive Iodine treatment of Hyperthyroidism? (3 things)

A
  1. Can’t be pregnant / get pregnant for 6 months
  2. Can’t go near anyone for few days after dose
  3. Can’t go near kids / pregnant women for 3 weeks after dose
26
Q

What are the complications of Hyperthyroidism? (4 things)

A
  1. Thyroid storm (life-threatening thyrotoxic crisis)
  2. HF
  3. Angina
  4. AF

#Phase 2.1: GI (29 decks)

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