15.4 Hyperthyroidism

Question 1

Hyperthyroidism

Answer 1

Increased BMR and sympathetic activity due to increased thyroid hormone

Question 2

How does thyroid hormone increase the BMR?

Answer 2

Increased synthesis of Na/K ATPase

Question 3

How does thyroid hormone increase sympathetic activity?

Answer 3

Increased expression of ß1-adrenergic receptors

Question 4

What are the clinical features of hyperthyroidism?

Answer 4

• Weight loss
• Heat intolerance
• Sweating
• Tachycardia
• Tremor
• Hypocholesterolemia

Question 5

What is the most common cause of hyperthyroidism?

Answer 5

Graves Disease

Question 6

Graves Disease

Answer 6

Auto-Ab IgG that stimulates the TSH receptor and increases the synthesis of thyroid hormone

Question 7

Who is the most common patient of Graves disease?

Answer 7

Women of childbearing age

Question 8

What are the clinical findings with Graves disease?

Answer 8

• Hyperthyroidism
• Diffuse goiter
• Pretibial myxedema
• Exophthalmos

Question 9

What are the lab findings in Graves disease?

Answer 9

• Increased T4
• Decreased TSH
• Hypocholesterolemia

Question 10

What is the treatment for Graves disease?

Answer 10

• Beta blockers
• Thioamide
• Radioiodine ablation

Question 11

Thyroid Storm

Answer 11

Elevated catecholamines and massive hormone excess that leads to hyperthermia, arrhythmia and vomiting - hypovolemic shock

Question 12

What is the treatment for thyroid storm?

Answer 12

• Beta blockers
• Steroids
• PTU

Question 13

Multinodular Goiter

Answer 13

Enlarged thyroid with multiple nodules due to iodine deficiency

Question 14

What is “toxic goiter?”

Answer 14

Rare form of multi nodular goiter that causes regions to become TSH independent and secrete thyroid hormone without the control of TSH