Like Be the first to like this Show Hyperthyroidism (Thyrotoxicosis)Essentials of Diagnosis
General Considerations Hyperthyroidism is caused by the increased secretion of thyroid hormone (Graves' disease, Plummer's disease, iodine [jodbasedow], amiodarone toxicity, TSH-secreting pituitary tumors, hCG-secreting tumors) or by other disorders that increase thyroid hormone levels without increasing thyroid gland secretion (factitious hyperthyroidism, subacute thyroiditis, struma ovarii, and, rarely, metastatic thyroid cancers that secrete excess thyroid hormone). The most common causes of hyperthyroidism are diffusely hypersecretory goiter (Graves' disease) and nodular toxic goiter (Plummer's disease). In all forms, the symptoms of hyperthyroidism are due to increased levels of thyroid hormone in the blood stream. The clinical manifestations of thyrotoxicosis may be subtle or marked and tend to go through periods of exacerbation and remission. Some patients ultimately develop hypothyroidism spontaneously or as a result of treatment. Graves' disease is an autoimmune disease—often with a familial predisposition—whereas the etiology of Plummer's disease is unknown. Most cases of hyperthyroidism are easily diagnosed on the basis of the signs and symptoms; others—eg, mild or apathetic hyperthyroidism—which occurs most commonly in the elderly—may be recognized only with laboratory testing for a suppressed TSH level. Thyrotoxicosis has been described with a normal T4 concentration, normal or elevated radioiodine uptake, and normal protein binding, but with increased serum T3 by RIA (T 3 toxicosis). T 4 pseudothyrotoxicosis is occasionally seen in critically ill patients and is characterized by increased levels of T4 and decreased levels of T3 due to failure to convert T4 to T3. Thyrotoxicosis associated with toxic nodular goiter is usually less severe than that associated with Graves' disease and is only rarely if ever associated with the extrathyroidal manifestations of Graves' disease such as exophthalmos, pretibial myxedema, thyroid acropathy, or periodic hypocalcemic paralysis. If left untreated, thyrotoxicosis causes progressive and profound catabolic disturbances and cardiac damage. Death may occur in thyroid storm or because of heart failure or severe cachexia.  Diagnostic algorithm for thyrotoxicosis. MNG = multinodular goiter; RAI = radioactive iodine; TSH = thyroid-stimulating hormone. Board Review Questions1. Choose the one best response to this question. Which of the following is not a manifestation or associated condition with Graves hyperthyroidism?
2. Choose the one best response to this question. Where does the arterial supply to the superior and inferior parathyroids originate from?
3. Choose the one best response to this question. A 56-year-old female is found to have symptoms of hypothyroidism with a painless, enlarged, firm, rubbery thyroid gland. FNA shows diffuse infiltration of the gland with lymphocytes and plasma cells. Which of the following best describes her condition?
Answers1. The correct answer is D. diffuse arthropathy. 2. The correct answer is B. inferior thyroid artery. 3. The correct answer is A. Hashimoto's thyroiditis.
Moseley Professor of Surgery, Harvard Medical School, Surgeon-in-Chief, Brigham Health & Dana-Farber Cancer Institute What are the clinical manifestation of hyperthyroidism?The classic symptoms of hyperthyroidism include heat intolerance, tremor, palpitations, anxiety, weight loss despite a normal or increased appetite, increased frequency of bowel movements, and shortness of breath. Goiter is commonly found on physical examination.
What are 3 symptoms of hyperthyroidism?The symptoms of hyperthyroidism can vary from person to person and may include:. Nervousness or irritability.. Fatigue.. Muscle weakness.. Trouble tolerating heat.. Trouble sleeping.. Tremor, usually in your hands.. Rapid and irregular heartbeat.. Frequent bowel movements or diarrhea.. Which clinical manifestation would the nurse assess in a patient with hyperthyroidism?Hyperthyroidism may manifest as weight loss despite an increased appetite, palpitation, nervousness, tremors, dyspnea, fatigability, diarrhea or increased GI motility, muscle weakness, heat intolerance, and diaphoresis.
What is a common clinical manifestation of juvenile hyperthyroidism?Signs of hyperthyroidism can include:
Sweat and sleep problems. Big appetite along with weight loss. Wide eyed stare including possible eyes bulging out. Other problems can include fainting and looser stool.
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Which of the following clinical manifestations are associated with hyperthyroidism?
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