Clinical signs & symptoms, risk factors, associated symptoms, and diagnosis
o HYPERTHYROIDISM (Thyrotoxicosis)
Grave’s disease- common etiology of hyperthyroidism
Autoimmune disease characterized by generation of abnormal IgG autoantibodies to thyroid peroxidase and thyroglobin -&g...
Clinical signs & symptoms, risk factors, associated symptoms, and diagnosis
o HYPERTHYROIDISM (Thyrotoxicosis)
Grave’s disease- common etiology of hyperthyroidism
Autoimmune disease characterized by generation of abnormal IgG
autoantibodies to thyroid peroxidase and thyroglobin -> binds to the
TSH receptors -> activating excessive glandular growth and hormone
production.
S/Sx:
heat intolerance
heightened sensitivity to SNS stimulation
nervousness
irritability
palpitations
tremors
increased heart rate
low TSH and TRH, increased iodine reuptake
goiter- enlargement of thyroid gland
disproportionate increased T3 production- HALLMARK of long-term
overstimulation of the gland.
Risk Factors:
DM
Pernicious anemia
Primary adrenal insufficiency
Vitiligo
Leukotrichia (prematurely gray hair)
Vitiligo
Drug compounds that contain iodine or affect iodine metabolism
Viruses and pregnancy (can trigger thyroiditis)
Diagnosis:
Low TSH, High T3 and T4 = primary hyperthyroidism
Low TSH, normal T3 and T4 = subclinical hyperthyroidism
, o HYPOTHYROIDISM
Primary:
defective hormone synthesis resulting from autoimmune thyroiditis,
endemic iron deficiency, or antithyroid drugs that were used to treat
hyperthyroidism
congenital defects or loss of tissue after treatment for hyperthyroidism
decreased thyroid hormone level -> hypothalamus -> increased TRH ->
increased TSH -> stimulates thyroid gland enlargement
Hashimoto’s thyroiditis- immune related disorder in which all
components of thyroid gland are injured, but especially the TSH
receptors.
Subacute thyroiditis- an inflammation of the thyroid often preceded by
a viral infection.
Congenital hypothyroidism- occurs in infants as a result of absent
thyroid tissue and hereditary defects in thyroid hormone synthesis
Secondary (less common):
Conditions that cause either pituitary or hypothalamic failure
TSH response is inadequate so that the gland is normal or reduced in
size, with both T3 and T4 synthesis equally reduced.
S/Sx:
Low basal metabolic rate
Cold intolerance
Lethargy
Slightly lowered body temperature
Myxedema (occurs in long-standing untreated hypothyroidism, sign of
severe hypothyroidism)
Pitting, boggy edema
Around the eyes
Hands
Shins
Supraclavicular fossae
Thickening of the tongue
Thickening of the laryngeal-pharyngeal membranes (thick,
slurred speech, hoarseness)
Risk Factors:
Primarily occurs in women older than 50yo
Family hx of thyroid disease or autoimmune disease
Type 1 DM
Rheumatoid arthritis
Currently taking anti-thyroid medications
Treated with radioactive iodine for thyroid cancer
Thyroid surgery
Radiation exposure to neck or upper chest area
Diagnosis:
High TSH, low T3 and T4
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