Hyperthyroidism
- 2. The thyroid gland is one of the largest endocrine gland in the body, and consists of two connected lobes. It is found in the anteriorneck,belowthe laryngealprominence (Adam's apple.
- 5. Hyperthyroidism is hyperactivity of the thyroid gland with sustained increase in synthesis and release of thyroid hormones.
- 6. Hyperthyroidism is a set of disorders that involve excess synthesis and secretion of thyroid hormones(T3 and T4) by the thyroid gland,which leads to the hypermetabolic condition of thyrotoxicosis.
- 7. The term thyrotoxicosis refers to the physiological effects or clinical syndrome of hypermetabolism that results from excess circulating levels ofT3 ,T4 or both.
- 8. Incidence Occurs in women more than men with highest frequency in persons 20 to 40 years old.
- 10. Most common cause (50-60%) An autoimmune disorder in which antibodies produced by immune system stimulate thyroid to produce too much thyroid hormone.
- 11. 15-20% cases A destructive release of preformed thyroid hormone.
- 12. Also called plummer disease 15-20% of cases Occurs more commonly in elderly,especially with long standing goiter
- 13. Caused by single hyperfunctioning follicular thyroid adenoma. Accounts 3-5 % of cases Benign monoclonal tumor that usually is larger than 2.5 cm Nuclear Scintigraphy scan shows only a single hot nodule
- 15. History and physical examination Ophthalmologic examination- ECG-atrial tachycardia Laboratory tests TFT(thyroid function test) T3 T4 TRH(thyroid releasing hormone) stimulation test
- 16. Radioactive iodine uptake(RAIU) A radioactive iodine uptake (RAIU) test uses a radioactive tracer and a special probe to measure how much tracer the thyroid gland absorbs from the blood.
- 17. The overall goal in the treatment of hyperthyroidism is to block the adverse effects of thyroid hormones and stop their oversecretion Drug therapy Antithyroid drugs eg. Propylthiouracil,methimazole -inhibits the synthesis of thyroid hormones. Blocks conversion of t4 to t3
- 18. Indications for antithyroid drugs: ▪ Patients with high likelihood of remission ▪ the elderly or others with comorbidities increasing surgical risk or with limited life expectancy ▪ moderate to severe active Graves’ ophthalmopathy (GO) ▪ Soon after starting radioactive I131therapy for 6 to 12 weeks
- 19. B adrenergic blockers e.g propanolo Inhibit adrenergic effects Indications ▪ Prompt control of symptoms ▪ treatment of choice for thyroiditis ▪ first-line therapy before surgery, radioactive iodine, and antithyroid drug
- 20. Radioactive iodine therapy Concentrates in the thyroid gland and destroys thyroid tissue High cure rates with single-dose treatment (80 percent); treatment of choice for ▪ Graves’ disease ▪ Multi nodular goitre, toxic nodules in patients older than 40 years, and In recurrent thyrotoxicosis
- 21. Surgical therapy Surgical treatment is reserved ▪ patient preference ▪ Pregnant women who can’t tolerate ATD child or adolescent intolerant
- 22. Thyroidectomy Total or near thyroidectomy ▪ for patients with coexistent thyroid cancer, sever ophthalmopathy, life treating reactions to antithyroid drugs Subtotal thyroidectomy is recommended for the rest bilateral subtotal thyroidectomy in which 1–2 grams of thyroid tissue is left on both sides
- 23. Fatigue related to hypermetabolic state with increased energy requirements. Imbalanced Nutrition: Less Than Body Requirements related to Increased metabolism (increased appetite/intake with loss of weight),Nausea/vomiting, diarrhea
- 24. Risk for ImpairedTissue Integrity related to alterations of protective mechanisms of eye: impaired closure of eyelid/exophthalmos
- 25. Topic :Consequences of hyperthyroidism in male and female fertility: pathophysiology and current management. Authors :Mintziori G, Kita M, Duntas L, Goulis DG. Journal : J Endocrinol Invest. Published on :2016 Mar 8
- 26. Abstract Thyroid hormone acts on the oocytes, sperm and embryo during fertilization, implantation and placentation. Both hypothyroidism and hyperthyroidism may influence fertility. However, evidence of the association of hyperthyroidism with infertility is scarce and sometimes conflicting. Thyroid hormone influences human reproduction via a variety of mechanisms at both the central and the peripheral level. Infertility may occur in hyperthyroid men and women, but it is usually reversible upon restoration of euthyroidism..
- 27. Topic :Endocrine disorders and osteoporosis Journal name: Nihon Rinsho Author name : KinoshitaY Year : 2015 Oct
- 28. Abstract Secondary osteoporosis is a bone disease characterized by decreased bone mass that predisposes fractures due to underlying disorders or medication. Disorders of the endocrine system, such as primary hyperparathyroidism, hyperthyroidism, hypogonadism, growth hormone deficiency, Cushing's syndrome, and anorexia nervosa frequently cause secondary osteoporosis. In those diseases, hormone excess or deficiency affects functions of osteoblasts, osteocyte, and osteoclasts, leading to aberrant bone remodeling.
- 29. Anatomy and physiology of thyroid gland Definition Causes Sign and symptoms Diagnosis Management
- 30. Hyperthyroidism is the production of too much thyroxine hormone which can increase metabolism. Symptoms include unexpected weight loss, rapid or irregular heartbeat, sweating and irritability.
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