| What is hyperthyroidism and what are its types? | It is increased thyroid hormones, may be overt (low TSH with elevated T3/T4)
or subclinical (low or undetectable TSH with normal T3 T4 |
| What are the symptoms of hyperthyroidism? | Hyperactivity, anxiety, weightloss, heat intolerance, increased sweating (Perspiration) , palpitation, tremor |
| what are the signs of hyperthyroidism and thyrotoxicosis? | Tachycardia, systolic HTN with wide PP, warm moist skin, Lid lag, stare, hand tremor, muscle weakness, ophthalmopathy, pertibial myxedema dermopathy (grave's disease) |
| How is the diagnosis of hyperthyoridism? | Blood test (Supressed TSH and elevated T3/T4- if mild only elevated T3, subclinical low TSH but normal T3 T4) |
| What are the causes of primary hyperthyroidism? | 1. Graves’ disease
2. Toxic adenoma and TMNG
3. Subacute thyroiditis
4. hCG-induced gestational hyperthyroidism
5. Trophoblast tumors (hydatiform mole, choriocarcinoma)
6. Struma ovarii
7. Iodine-induced hyperthyroidism |
| What are the causes of secondary hyperthyroidism? | Pituitary adenoma |
| What is grave's disease? | Autoimmune disorder causing hyperthyroidism.
Due to presence of thyroid receptor antibodies stimulate thyroid gland --> overfunction. |
| What are labs seen in grave's disease? | TSab (antibodies, AKA TSI/ LATS (long acting thyroid stimulator)/TRab (thyroid receptor Ab)
Specfic test (over 69-90%) for grave's
anti-TPO present 85% but not specific |
| How is the iodine uptake in grave's disease? | Very much increased with a butterfly appearance |
| What is toxic adenoma? | Somatic mutation leading to thyroid adenoma, overfunctioning, called hot nodule, may be overt or subclinical hyperthyroidism (may be multiple hot nodules) |
| What is subacute thyroditis? | Excessive release of thyroid hormones due to a damage in the gland, resolves alone after 3 months and causes TSH suppression
FT4 and T3 may be normal, and antibodies may be also normal
On scan appears transparent since thyroid hormones are leaking |
| What is hCG induced gestational hyperthyroidism? | hCG works as a week TSH, stimulates thyroid, causes hyperthyroidism in first trimester, resolves 14-16 weeks of gestation. |
| What is trophoblast tumors (choriocarcinoma)? | Increased hCG by a cancer causing hyperthyroid |
| What is struma ovary? | Ovarian teratoma causing autonomous function of thyroid |
| What is iodine-induced hyperthyroidism? | Excessive iodine intake causing increased thyroid hormone production, like in latent grave's or MNG.
Happens after IV dye or medication with high iodine (Amiodarone) |
| What is secondary hyperthyroidism? | Pituitary adenoma producing TSH, excess f T4 with no inhibition of TSH
Labs: abnormally normal TSH with high fT4 |
| How is the management of hyperthyroidism? | Medications (Methimazol, PTU (inhibit thyroid production), Beta blockers (reduce symptoms (tachycardia and tremors))
Radioactive iodine (I-131 accumulates in thyroid, used in grave's , toxic adenoma and TMNG, cant treat thyroiditis)
Surgery (total (grave's) or hemi (toxic adenoma) thyroidectomy) |
