Hyperthyroidism Flashcards Preview

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Flashcards in Hyperthyroidism Deck (21):
0

Treatment of hyperthyroidism?

Antithyroid drugs, radioactive iodine ablation

1

Effect of hyperthyroidism on Neuromuscular system?

Brisk reflexes, inability to concentrate, proximal muscle weakness, insomnia

2

Effect of hyperthyroidism on cardiac system?

Wide pulse pressure, heart murmurs, tachycardia, AFIB, High-output heart failure

3

Effect of hyperthyroidism on G.I. tract?

Increased food intake with weight loss and hyperdefecation

4

Effect of hyperthyroidism on eyes?

Lid lag and retraction upper eyelid

Exophthalmos if Graves' disease

5

Effect of hyperthyroidism on the reproductive system?

Women: infertility and oligomenorrhea

Men: reduced sperm count, impotence, gynecomastia

6

Effect of hyperthyroidism on skin?

Warm, moist, velvety, alopecia

7

Effect of hyperthyroidism in older patients?

Less adrenergic features and instead present with depression, weight loss, Afib, worsening angina or CHF

8

Thyroid storm?

Decompensated thyrotoxicosis
Tachycardia >140
Fever (104-106)
Agitation/delirium
Vomiting and diarrhea

9

Treatment of thyroid storm?

1 fluids
2 antibiotics
3 Anti-thyroid medications:
IODINE SOLUTION (to block the release of thyroid hormone,)
PROPRANOLOL to control adrenergic symptoms, GLUCOCORTICOIDS to decrease T4 to T3 conversion

10

Causes of thyrotoxicosis?

1 Graves' disease
2 toxic multinodular goiter
3 adenoma
4 thyroiditis
5 medications

11

Graves' disease: epidemiology? Mechanism?

Women ages 30 to 50
Autoantibodies that activate TSH receptor

12

Thyrotoxicosis in pregnant patients can cause?

Antibodies cross placenta and cause neonatal thyrotoxicosis

13

Physical exam signs of Graves' disease?

Goiter, thyroid bruit, Exophthalmus, diplopia, dermopathy (Raised hyperpigmented orange peel papules) and myxedema

14

Confirmatory tests for Graves disease?

1. Thyroid-stimulating immunoglobulin
2. Thyroid uptake scan showing diffusely increased iodine uptake

15

Methimazole versus PTU?

Peripheral effects versus the peripheral and central effects

16

Toxic multinodular corridor: test? treatment?

Focal increased iodine uptake on scan

Radioactive iodine or surgery

17

Pummer disease: Mechanism? Radioactive scan results? Risk of malignancy if?

Hyper functioning adenoma (no symptoms unless nodule >3 cm)

Iodine scan shows hot nodule with suppressed rest of gland (Flag of Japan)

Hot nodules are never malignant. Cold nodules have 5 to 10% risk

18

Subacute thyroiditis caused by? Sx? Treatment?

de Quervain is an inflammatory viral illness with thyroid pain and tenderness. Last for several weeks to months. NSAIDs and beta blockers

19

Medication can cause hyperthyroidism?

Amiodarone

20

Masses outside thyroid that can cause thyrotoxicosis?

Pituitary adenoma
Hydatidiform mole
Choriocarcinoma
Ovarian teratomas (struma ovarii)

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