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Endocrine**

Thyroid Parathyroid

QuestionAnswer
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
Created by: LauraHall
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