Thyroid: Hyperthyroidism Flashcards
(23 cards)
What is Hyperthyroidism?
Over production of thyroid hormones T3 (Triiodothyronine) and T4 (Thyroxine)
Also known as Thyroidtoxicosis, which is an umbrella term that includes hyperthyroidism.
What are the types of Hyperthyroidism?
- Primary Hyperthyroidism
- Secondary Hyperthyroidism
- Subclinical Hyperthyroidism
Each type has distinct causes and characteristics.
What characterizes Primary Hyperthyroidism?
HIGH T3/T4, LOW TSH
Results from thyroid pathology.
What is the most common cause of Primary Hyperthyroidism?
Grave’s Disease
An autoimmune disease with TSH receptor antibodies that stimulate TSH receptors.
List some causes of inflammation (thyroiditis) leading to Primary Hyperthyroidism.
- De Quervain’s thyroiditis
- Hashimoto’s thyroiditis
- Postpartum thyroiditis
- Drug-induced thyroiditis
These conditions often initially cause hyperthyroidism followed by hypothyroidism.
What is a solitary thyroid nodule?
A single thyroid hormone producing nodule on the thyroid that can be surgically removed
This condition is associated with Primary Hyperthyroidism.
What is Toxic multinodular goitre?
Unregulated production of T3/T4 from nodules on the thyroid, most common in patients aged 50 and older
A cause of Primary Hyperthyroidism.
What characterizes Secondary Hyperthyroidism?
HIGH TSH and HIGH T3/T4
Results from pituitary pathology.
What is the cause of Secondary Hyperthyroidism?
Pituitary Adenoma
This condition leads to excessive production of TSH.
What characterizes Subclinical Hyperthyroidism?
T3/T4 NORMAL and TSH is LOW
Patients may have absent or mild symptoms.
What are common symptoms of Hyperthyroidism?
- Anxiety/irritability
- Sweating/heat intolerance
- Tachycardia
- Weight loss/fatigue/insomnia
- Frequent loose stools
- Sexual dysfunction
- Brisk reflexes on examination
- Diarrhoea
These symptoms indicate increased metabolic activity.
What are specific features of Graves’ disease?
- Diffuse goitre
- Eye disease (exophthalmos)
- onycholysis (loose nails)
- Pretibial myxoedema
- Thyroid acropachy (clubbing, swelling of the hands and feet, and periosteal new bone formation)
These features are associated with TSH receptor antibodies.
What is the first-line treatment for Primary Hyperthyroidism?
Carbimazole
Treatment duration is typically 12-18 months.
What are the risks associated with Carbimazole?
- Acute Pancreatitis
- Agranulocytosis
Agranulocytosis may present with a sore throat.
What is the second-line treatment for Primary Hyperthyroidism?
Propylthiouracil
This medication carries risks of severe liver damage and agranulocytosis.
What is the purpose of Radioactive Iodine treatment?
Emits radiation to kill a proportion of thyroid cells
Remission can last up to 6 months, requiring long-term Levothyroxine.
What precautions must be taken after Radioactive Iodine treatment?
- Women cannot be pregnant or breast feeding
- Men must not father children for 4 months
- Limit contact with children and pregnant women
These precautions are to ensure safety post-treatment.
What is the role of Beta-Blockers in Hyperthyroidism treatment?
To block adrenaline-related symptoms
Propanolol is often the first choice as a non-selective beta-blocker.
What is a surgical treatment option for Hyperthyroidism?
Thyroidectomy
This often leads to lifelong Levothyroxine treatment due to hypothyroidism.
What characterizes De Quervain’s (subacute) Thyroiditis?
Temporary inflammation with three stages: thyrotoxicosis, hypothyroidism, return to normal
It often follows an infection.
What are the investigations for De Quervain’s Thyroiditis?
Raised ESR and CRP
These tests indicate inflammation.
What is the main symptom of De Quervain’s Thyroiditis?
Thyroid tenderness
It may present with flu-like illness and raised inflammatory markers.
What is the treatment for Stage 1 of De Quervain’s Thyroiditis?
Supportive treatment with NSAIDs, B-blocker, Levothyroxine
This stage is characterized by excessive thyroid hormone.
