Flashcards in Hyperthyroidism Deck (21):
Treatment of hyperthyroidism?
Antithyroid drugs, radioactive iodine ablation
Effect of hyperthyroidism on Neuromuscular system?
Brisk reflexes, inability to concentrate, proximal muscle weakness, insomnia
Effect of hyperthyroidism on cardiac system?
Wide pulse pressure, heart murmurs, tachycardia, AFIB, High-output heart failure
Effect of hyperthyroidism on G.I. tract?
Increased food intake with weight loss and hyperdefecation
Effect of hyperthyroidism on eyes?
Lid lag and retraction upper eyelid
Exophthalmos if Graves' disease
Effect of hyperthyroidism on the reproductive system?
Women: infertility and oligomenorrhea
Men: reduced sperm count, impotence, gynecomastia
Effect of hyperthyroidism on skin?
Warm, moist, velvety, alopecia
Effect of hyperthyroidism in older patients?
Less adrenergic features and instead present with depression, weight loss, Afib, worsening angina or CHF
Vomiting and diarrhea
Treatment of thyroid storm?
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
Causes of thyrotoxicosis?
1 Graves' disease
2 toxic multinodular goiter
Graves' disease: epidemiology? Mechanism?
Women ages 30 to 50
Autoantibodies that activate TSH receptor
Thyrotoxicosis in pregnant patients can cause?
Antibodies cross placenta and cause neonatal thyrotoxicosis
Physical exam signs of Graves' disease?
Goiter, thyroid bruit, Exophthalmus, diplopia, dermopathy (Raised hyperpigmented orange peel papules) and myxedema
Confirmatory tests for Graves disease?
1. Thyroid-stimulating immunoglobulin
2. Thyroid uptake scan showing diffusely increased iodine uptake
Methimazole versus PTU?
Peripheral effects versus the peripheral and central effects
Toxic multinodular corridor: test? treatment?
Focal increased iodine uptake on scan
Radioactive iodine or surgery
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
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
Medication can cause hyperthyroidism?