Hyperthyroidism (thyrotoxicosis)

Question 1

Hyperthyroidism Pathology

Answer 1

Hypersecretion of TH

Question 2

Primary Hyperthyroidism Pathology

Answer 2

• Thyroid gland pathology - Grave’s disease, toxic multinodular goitre, thyroid (toxic) adenoma
• Low TSH
• Raised TH

Question 3

Secondary Hyperthyroidism Pathology

Answer 3

• TSH-secreting pituitary adenoma
• Raised TSH
• Raised TH

Question 4

Subclinical Hyperthyroidism

Answer 4

• Low TSH

- Normal TH

Question 5

Grave’s Disease Pathology

Answer 5

Antibody production which mimic TSH (bind to/block) receptor.

Question 6

Toxic Multinodular goitre

Answer 6

Characteristic goitre with absence of Grave’s disease

Question 7

Hyperthyroidism Symptoms

Answer 7

• Weight loss
• Heat intolerance (sweating)
• Muscle weakness
• Hypereflexia, tremors
• Nervousness, irritability, anxiety
• Palpitations
• Diarrhoea
• Infertility, light periods
• Difficulty sleeping
• Hair loss
• Proptosis
• Clubbing
• Gynaecomastia

Question 8

Hyperthyroidism Investigations

Answer 8

• TSH
• TFTs
• Blood test: antibodies (TSH, TPO)
• Biopsy

Question 9

Hyperthyroidism Management

Answer 9

• Antithyroid drugs
• Radioactive iodine
• Surgery
• Beta blockers/CCBs