Flashcards in Hyperthyroidism Deck (43):
What are the hormone levels is primary hyperthyroidism?
What are the hormone levels in secondary hyperthyroidism?
What are the causes of hyperthyroidism?
What is Grave's disease?
What is the etiology for Grave's disease?
What are the risk factors for Grave's disease
High iodine intake
What is the prognosis of Grave's disease?
What tests can you do for Grave's disease?
High T3/T4, Low TSH
Thyroid antibodies positive
Scintigraphy: high uptake/Ultrasound
What are the signs of Grave's disease?
Pretibial myxoedema (doughy)
Smooth symmetrical goitre
Why does pretibial myxoedema happen in Grave's disease?
pretibial accumulation of hydrophillic mucopolysaccharide at the dermis
What antibodies can you look for in Grave's disease?
Anti TPO (70-80%)
Anti TG (30-50%)
TSH receptor antibody (70-100%)-stimulating
What is a nodular cause of hyperthyroidism?
toxic nodule (adenoma)
What are sources of iodine overdose?
What medications can cause hyperthyroidism?
What are the GI symptoms of hyperthyroidism?
frequent loose bowel movements
What are the gynae symptoms of hyperthyroidism?
oligomenorrhoea (less frequent periods)
What are the opthomogical symptoms of hyperthyroidism?
What are the CNS symptoms of hyperthyroidism?
What are the hair and nail changes in hyperthyroidism?
Rapidly growing nails
What are the MSK symptoms of hyperthyroidism?
Muscle weakness (especially proximal limbs)
What are the metabolic changes in hyperthyroidism?
What are the thermogenic changes in hyperthyroidism?
How does a nodular thyroid present?
gland feels nodular
What would antibody screening show in a nodular thyroid?
What are the hormone levels with a nodular thyroid?
What is De Quiveran's thyroiditis?
What is the etiology of De Quiveran's?
What are the risk factors for developing De Quiveran's?
Viral trigger (associated viral symptoms eg sore throat)
What is the length of disease in De Quiveran's
Resloves in a few months
What is the hormone level profile in De Quiveran's?
Euthyroid (normal T3/T4)
Hyperthyoid (High T3/T4)
Hypothyroid (Low T3/T4)
Euthyroid (normal T3/T4)
What are the hormone levels in sub-clinical hyperthyroidism?
What is the 1st line treatment for hyperthyroidism?
What mechanism does carbimazole target?
Iodine attraction to tyrosine within thyroglobulin colloid
When should carbimazole not be used and what should be used instead?
use propylthiouracil (PTU)
What other drugs should be used to manage symptoms of hyperthyroidism and why?
symptoms are sympathomemetic
therefore dulls down sympathetic response
How should Grave's disease be treated?
High dose over 12-18months
Then stop treatment to prevent hypothyroid
What treatments for hyperthyroidism would be considered after drug therapy?
What precautions does the patient have to take after radioiodine?
avoid long contact with children or pregnant women
Don't share a bed with someone else
Avoid pregnancy for 6 months
Ensure not pregnant
What are the risks of radioiodine treatment?
especially in Grave's
What are the risks of surgery in hyperthyroidism?
recurrent laryngeal nerve palsy
What are the complications of hyperthyroidism in pregnancy?
thyroid crisis in labour
transient neonatal thyrotixicosis
How is it difficult to distinguish hyperthyroidism from nausea in pregnancy?
lack of weight gain