ICL Hyperthyroidism - Week 12

Question 1

Causes of hyperthyroidism.

Answer 1

• Toxic multinodular goitre
• Graves’ disease (most common)
• Toxic thyroid adenoma
• Thyroiditis
• HT
• De Quervain’s thyroiditis
• Post-partum thyroidits
• Amiodarone
• Excess iodine
• Subacute thyroiditis
• Secondary pituitar disorder

Question 2

Risk factors for hyperthyroidism.

Answer 2

• Female
• FHx thyroid disease
• > 60 yo – toxic multinodular goitre
• <60 yo – Grave’s disease
• Excess iodine consumption
• Hormone changes during menopause/pregnancy -> temporary hyperthyroidism
• Viral infection causing thyroiditis
• PPMHx autoimmune condition (e.g., T1DM).

Question 3

What is a goitre? 2 x types.

Answer 3

Goitre – observable enlargement of the thyroid.
* Multinodular toxic goitre – enlargement in nodes, which is associated w excessive hormone production.
* Diffuse non-toxic goitre – uniform enlargement of the thyroid gland, can be obstructive, but has minimal effect on thyroid function.
NB: Also present in hypothyroidism, due to iodine deficiency .

Question 4

What are goitrogens? Provide examples.

Answer 4

Goitrogens – goitre-causing agents which interfere w thyroid hormone production to promote thyroid tissue growth (e.g., excess iodine or iodine-deficiency, cruciferous veggies, soy, cabbage, brussel sprouts, sweet potato, lima beans).

Question 5

Aetiology of Graves’

Answer 5

Thyroid stimulating immunoglobulin/antibody -> bind to the TSH receptor -> TSH secretion -> thyromegaly & hyperthyroidism (antibodies mimick TSH).

Question 6

Test used to diagnose Graves’

Answer 6

TRAb
Thyrotropin receptor antibodies.