Graves' Disease Treatment Options
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Questions and Answers

What is the most common cause of hyperthyroidism?

  • Lymphocytic thyroiditis
  • Graves' disease (correct)
  • Subacute thyroiditis
  • Toxic solitary adenoma
  • Hyperthyroidism is the clinical effect of excess thyroid hormone secretion usually from gland hypofunction.

    False

    What is the definition of thyrotoxicosis factitia?

    Excess exogenous L-thyroxine.

    Thyrotoxicosis can be caused by excess _______________________ , as may occur in people taking certain expectorants or iodine-containing contrast agents for imaging studies.

    <p>iodine</p> Signup and view all the answers

    Match the following conditions with their corresponding causes of hyperthyroidism:

    <p>Graves' disease = Autoimmune disorder Toxic multinodular goiter = Intrinsic thyroid autonomy Subacute thyroiditis = Transient hyperthyroidism Thyrotoxicosis factitia = Excess exogenous L-thyroxine</p> Signup and view all the answers

    What is the name of the disease that is a non-autoimmune disease of the elderly associated commonly with arrhythmia and CHF?

    <p>Plummer disease</p> Signup and view all the answers

    Ectopic thyroid tissue is a extrathyroid source of hormones.

    <p>True</p> Signup and view all the answers

    What is the name of the antibody that stimulates the thyroid to secrete T4 and T3 in Graves' disease?

    <p>Thyroid stimulating immunoglobulin (TSI) or TSH receptor antibody.</p> Signup and view all the answers

    What is the term for the painful inflammation of the thyroid gland that can cause transient hyperthyroidism?

    <p>Subacute thyroiditis</p> Signup and view all the answers

    Hyperthyroidism can be caused by certain _______________________ , such as amiodarone, alpha interferon, and lithium.

    <p>drugs</p> Signup and view all the answers

    Study Notes

    Indications of Hyperthyroidism

    • Large thyroid gland
    • Multiple symptoms of thyrotoxicosis
    • High levels of thyroxine
    • High titers of TSI

    Treatment of Hyperthyroidism

    • Radioactive iodine as first-line therapy, aiming to destroy the gland and induce hypothyroidism
    • 3-Thyroidectomy (usually total), carrying a risk of damage to recurrent laryngeal nerve and hypoparathyroidism
    • Subtotal thyroidectomy, indicated in pregnancy, children, and cases with compressive symptoms

    Complications of Thyrotoxicosis

    • Heart failure (thyrotoxic cardiomyopathy) and angina
    • Osteoporosis
    • Ophthalmopathy
    • Gynaecomastia
    • Thyroid storm
    • Atrial fibrillation (seen in 10-25% of cases)

    Subclinical Hyperthyroidism

    • Defined as low TSH with normal T4 and T3
    • Associated with a 41% increase in relative mortality from all causes
    • Management involves confirming persistent suppressed TSH, ruling out non-thyroidal causes, and considering treatment if necessary

    Skin Manifestations of Hyperthyroidism

    • Excessive sweating and heat intolerance
    • Warm and moist skin
    • Palmar erythema, fine and silky hair
    • Onycholysis (separation of finger nail from nail bed) and Plummer's nails

    Ocular Signs of Hyperthyroidism

    • Staring due to lid retraction
    • Infrequent blinking
    • Lid lag

    Gastrointestinal Manifestations of Hyperthyroidism

    • Frequent bowel movements
    • Vomiting
    • Weight loss despite increased appetite

    Genital Manifestations of Hyperthyroidism

    • Menstrual irregularity (oligomenorrhea) and infertility in women
    • Decreased libido and erectile dysfunction in men

    Signs of Graves' Disease

    • Eye disease (exophthalmos, ophthalmoplegia)
    • Pretibial myxoedema
    • Thyroid acropachy

    Diagnosis of Graves' Disease

    • Made on history and physical exam
    • Lab studies include decreased TSH, high serum free T4 and T3, elevated RAIU, and elevated TSI, antithyroglobulin, and antimicrosomal antibodies

    Treatment of Graves' Disease

    • Drugs: beta-blockers for rapid control of symptoms and antithyroid medications to control high thyroid hormones

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    Description

    This quiz covers the treatment options for Graves' disease, including antithyroid therapy and radioactive iodine, and their associated outcomes.

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