Hyperthyroidism/Graves Disease Flashcards
What are the common examination findings?
Inspection - Thin, fidgety, hot
Hands - Tremor, thyroid acropachy, palmar erythema
Pulse - Tachycardic, irregular
BP - Hypertensive
Eyes - Exopthalmos, lig lag, diplopia
Neck - Goitre, Bruit
Legs - Pretibial myxodema
Reflexes - Hyperreflexic
Proximal myopathy so problems getting out of the chair
What are the investigations?
To finish the exam i would like to - Neurological examination, CVS
By the bed - History, obs
Bloods - TFTs plus antibodies, FBC for anaemia (normocytic) bone studies as can have raised calcium
Other - ECG for heart signs, Thyroid scan
ECG IF YOU ARE THINKING OR SUSPECTING AF
What are the key investigation findings?
TFTS:
Primary - low TSH and high T4 - Graves
Secondary - High TSH and high T4
Anti TSH - Graves
ECG may show AF
Anaemia and hypercalcaemia
GRAVES TRIAD - thyroid acropachy, opthalmoplegia, pre tibial myxodema
What is the treatment?
Conservative - Explain what it is and the need for regular monitoring
Medical - B blockers for symptoms,
Block and replace - Carbimazole and thyroxine or radioiodine
Surgical - Complete or partial thyroidectomy
What can cause hyperthyroid?
- AI history
- Infection - Viral - tender and raised ESR
- Toxic goitre - single or multinodular
- Drugs
