HYPERTHYROIDISM

• Hyperthyroidism are disorders that involve excess synthesis and secretion of thyroid hormone (T3, T4) by thyroid gland leading to thyrotoxicosis.

Hyperthyroidism are-

• Primary hyperthyroidism
• Thyrotoxicosis without hyperthyroidism
• Secondary hyperthyroidism

Primary hyperthyroidism-

• Diffuse toxic goiter (Grave’s disease)
• Toxic multinodular goiter (Plummer’s disease)
• Toxic nodule (solitary nodule/Toxic adenoma)
• Jod- Basedow’s thyrotoxicosis
• Struma ovary
• Drugs (antiarrhythmic drug- amidarone)
• Mc Cune Albright syndrome
• Thyroid malignancy

Secondary hyperthyroidism-

• TSH- secreting pituitary adenoma
• Thyroid hormone resistance syndrome
• Gestational thyrotoxicosis
• Chorionic gonadotropin secreting tumours

Thyrotoxicosis without hyperthyroidism-

• Thyroiditis
• Thyrotoxicosis factitia
• Subacute thyroiditis/ de Quervain’s

ETIOLOGY-

• Thyroid nodule
• Excessive iodine intake
• Grave’s disease
• Medication
• Thyroiditis
• Smoking
• Trauma

CLINICAL FEATURES

• Hyperactivity (Most common)
• Irritability, dysphoria
• Heat intolerance & sweating (moist skin)
• Fatigue, weakness, pseudoclubbing (plummer nail), exophathalmos
• Weight loss, increased BMR
• Diarrhoea, polyuria
• Oligo or amenorrhea, loss of libido
• Tachycardia, facial flushing
• Tremor, goiter
• Lid retraction
• Gynecomastia
• Hypocalcemia, hyperglycemia, low lipid

  

INVESTIGATIONS-

• ECG- atrial tachycardia
• TFT, T3, T4, TRH stimulation test

TREATMENT-

• Antithyroid drugs-  propylthiouracil (safe in pregnancy), methimazole
• Beta adrenergic blockers (propanol)- slows heart rate, reduces tremors and controls anxiety.
• Radioactive iodine therapy – ¹³¹I is used
• Surgical treatment for females who cant tolerate ATD
• Thyoridectomy

Don’t Forget to Solve all the previous Year Question asked on HYPERTHYROIDISM