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Endocrine**
Thyroid Parathyroid
Question | Answer |
---|---|
Hyperthyroidism | A sustained increase in synthesis and release of thyroid hormones by thyroid gland Occurs more often in women Highest frequency in 20- to 40-year-olds Most common form caused by Graves’ disease |
Graves’ Disease Etiology and Pathophysiology | Autoimmune disease of unknown etiology Diffuse thyroid enlargement Excessive thyroid hormone secretion |
Graves’ Disease Precipitating factors | Excessive TSH from pituitary gland Insufficient iodine supply Infection Stressful life events |
Hyperthyroidism Clinical Manifestations | Intolerance to heat ↑ Sensitivity to stimulant drugs Elevated basal temperature Exophthalmos |
Hyperthyroidism Geriatric symptoms | Anorexic Apathetic Depression Confusion Angina Heart failure |
Hyperthyroidism Diagnostic Studies | History Physical examination Ophthalmologic examination ECG Radioactive iodine uptake (RAIU) Indicated to differentiate Graves’ disease from other forms of thyroiditis |
Hyperthyroidism Laboratory tests | TSH Free thyroxine (free T4)—not converted to T3 Total T3 and T4 |
Hyperthyroidism Antithyroid drugs | Propylthiouracil (PTU) Methimazole (Tapazole) Iodine β-Adrenergic blockers |
Propylthiouracil (PTU) | Also blocks conversion of T4 to T3 Treats HYPERthyroidism |
Iodine | Used with other antithyroid drugs in preparation for thyroidectomy or treatment of crisis Large doses rapidly inhibit synthesis of T3 and T4 and block their release into circulation |
Radioactive iodine therapy (RAI) | Treatment of choice in nonpregnant adults Damages or destroys thyroid tissue Delayed response 2 to 3 months |
Radioactive iodine therapy (RAI) | Treated with antithyroid drugs and Inderal before and during first 3 months of RAI Instruct patient to use straw Radiation precautions |
β-Adrenergic blockers | Symptomatic relief of thyrotoxicosis Propranolol (Inderal) administered with other antithyroid agents |
Surgical therapy Indications | Unresponsive to drug therapy Large goiters causing tracheal compression Possible malignancy Individual not a good candidate for RAI |
Before surgery | Antithyroid drugs, iodine, and β- adrenergic blockers may be administered To achieve euthyroid state To control symptoms |