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  • Hyperthyroidism: - 60% Due To Grave's Disease - 40% Due To Miscellaneous Causes

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    Leitavia D.
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    Hyperthyroidism and hypothyroidism are caused by various conditions that result in excessive or insufficient thyroid hormone levels. The most common causes of hyperthyroidism are Grave's disease and toxic multinodular goiter, while Hashimoto's thyroiditis is the leading cause of hypothyroidism. Diagnosis involves measuring thyroid hormone levels, and treatments aim to control hormone levels through medications, radioactive iodine, or surgery.

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    Hyperthyroidism and hypothyroidism are caused by various conditions that result in excessive or insufficient thyroid hormone levels. The most common causes of hyperthyroidism are Grave's disease and toxic multinodular goiter, while Hashimoto's thyroiditis is the leading cause of hypothyroidism. Diagnosis involves measuring thyroid hormone levels, and treatments aim to control hormone levels through medications, radioactive iodine, or surgery.

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    101 visualizzazioni6 pagine

    Hyperthyroidism: - 60% Due To Grave's Disease - 40% Due To Miscellaneous Causes

    Caricato da

    Leitavia D.
    Hyperthyroidism and hypothyroidism are caused by various conditions that result in excessive or insufficient thyroid hormone levels. The most common causes of hyperthyroidism are Grave's disease and toxic multinodular goiter, while Hashimoto's thyroiditis is the leading cause of hypothyroidism. Diagnosis involves measuring thyroid hormone levels, and treatments aim to control hormone levels through medications, radioactive iodine, or surgery.

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    Attribution Non-Commercial (BY-NC)
    Scarica in formato PPTX, PDF, TXT o leggi online su Scribd
    Segnala contenuti inappropriati
    di 6

    Hyperthyroidism

    • 60% due to Grave’s Disease


    • 40% due to miscellaneous causes:
    – Thyroiditis, toxic adenomas, TSH-secreting
    pituitary tumors, struma ocarii, & hCG-secreting
    tumors
    • Diagnosis
    – Increased T3 and T4
    – Decreased TSH
    • Except in TSH-secreting tumors
    Hypothryoidism Causes
    Etiology Clinical Manifestations
    Grave’s Disease •TSI binds TSH receptor on •Diffuse nontender goiter
    thyroid gland; leads to ↑ T3/T4 with bruit
    (diffuse uptake on thyroid scan) •Infiltrative ophthalmopathy
    •Associated w/ other (proptosis, extraocular
    autoimmune disorders muscle dysfunction)
    •Pretibial myxedema
    Plummer’s Disease (toxic •Hyperfunctioning areas that •Less severe than Grave’s
    multinodular goiter) make ↑ T3/T4 (patchy uptake •Associated w/ life-
    on thyroid scan) threatening arrhythmias &
    •More common in elderly CHF
    Subacute Thyroiditis (de •Inflammation of thyroid •Thyroid gland firm, painful,
    Quervain’s thyroiditis) glandspilling of thyroid tender
    hormonetransient •Fever
    hyperthyroidism •Increased ESR
    •Usually preceded by upper •Pain radiating to ears, neck
    respiratory infection & arm
    Treatment
    • Thionamides (PTU & methimazole) to inhibit thyroid hormone
    synthesis; PTU also inhibits peripheral conversion of T4 to T3
    – Mechanism: Inhibits oxidation & organification of iodine, a required step in
    thyroid hormone synthesis
    – Both cross the placenta & are contraindicated in pregnancy; PTU is used
    during lactation
    – Side effects=rash, urticaria, fever, nausea; major effects=agranulocytosis,
    thrombocytopenia, acute hepatic necrosis & vasculitis
    • β-Blockers (propanolol) to control the adrenergic symptoms
    (sweating, tachycardia, tremor)
    • Radioactive Iodine to destroy thyroid function
    – Side effects=metallic taste, excessive salivation, diarrhea, rash
    • Surgery
    Signs & Sypmtoms
    Hyperthyroidism Hypothyroidism

    Symptoms Hyperactive, irritable Difficulty concentrating, Poor memory

    Heat intolerance, sweating Cold intolerance

    Palpitations Dyspnea

    Fatigue, weakness, Insomnia Fatigue, weakness, lethargy

    Diarrhea, polyuria Constipation

    Oligomenorrhea, loss of libido Menorrhagia

    Weight loss Weight gain, poor appetite

    Impaired hearing, hoarse voice (deep voice)

    Parasthesias

    Tachycardia Bradycardia
    Signs
    Tremor Delayed Tendon reflex relaxation

    Goiter Peripheral edema

    Warm, moist skin Dry, coarse skin & Hair loss (Diffuse alopecia)

    Proximal muscle weakness Carpal tunnel syndrome

    Lid retraction, lid lag Puffy face, hands, & feet (myxedema)

    Gynecomastia Diastolic Hypotension


    Hypothyroidism
    • 95% cases are 1°: Hashimoto’s thyroiditis, Riedel’s
    thyroiditis, iodine deficiency, & surgical destruction
    • 2° causes=failure of the pituitary gland
    • 3° causes=failure of the hypothalamus
    • Diagnosis
    – T3/T4/TSH/TRH
    • All are helpful to diagnose & distinguish among 1°, 2°, and 3° causes
    – Antimicrosomal antibodies to test for Hashitmoto’s Thyroiditis
    – Imaging of Pituitary & hypothalamus for tumor
    Treatment
    • Levothyroxine (T4) replacement
    – Levothyroxine is a T4 analog that binds to nuclear
    receptors. This leads to ↑ protein synthesis, ↑
    metabolic rate,↑ β-receptorsincreased
    sensitivity to catecholamines
    – Side effects=signs & symptoms of hyperthyroidism
    • Use emperic adrenal replacement therapy &
    Liothyronine when myxedema coma is involved
    – Liothyronine can precipitate heart failure

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