MSEM105.pdf

11/20/23, 1:06 AM Realizeit for Student Hyperthyroidism Hyperthyroidism, a common endocrine disorder, is a form of thyrotoxicosis resulting from an excessive synthesis and secretion of endogenous or exogenous thyroid hormones by the thyroid (Norris, 2019). The most common causes are Graves disease...

11/20/23, 1:06 AM Realizeit for Student Hyperthyroidism Hyperthyroidism, a common endocrine disorder, is a form of thyrotoxicosis resulting from an excessive synthesis and secretion of endogenous or exogenous thyroid hormones by the thyroid (Norris, 2019). The most common causes are Graves disease, toxic multinodular goiter, and toxic adenoma. Other causes include thyroiditis (inflammation of the thyroid gland) and excessive ingestion of thyroid hormone. Graves disease is an autoimmune disorder that results from an excessive output of thyroid hormones caused by abnormal stimulation of the thyroid gland by circulating immunoglobulins. This disease affects women eight times more frequently than men, with onset usually between the second and fourth decades. The disorder may appear after an emotional shock, stress, or an infection, but the exact significance of these relationships is not understood (Norris, 2019). Clinical Manifestations Patients with hyperthyroidism exhibit a characteristic group of signs and symptoms. Clinical manifestations are related to the increase in metabolic rate and increased oxygen consumption. The patient may appear anxious, seem restless and irritable, and exhibit fine tremors of the hands. The patient will be tachycardic and complain of palpitations. Heat intolerance will be noted with increased perspiration. Additional clinical manifestations include an increase in appetite, diarrhea, weight loss, and thin skin. Patients with Graves disease may present with exophthalmos and may exhibit reduced blinking and lid retraction. Treatment may not reverse ocular manifestations (Medford, 2019). Women experience changes in menstruation including oligomenorrhea (Lee & Khardori, 2018). Cardiac effects may include sinus tachycardia or arrhythmias, decreased cardiac output, increased pulse pressure, and palpitations; these changes may be related to increased sensitivity to catecholamines or to changes in neurotransmitter turnover. Myocardial hypertrophy and heart failure may occur if the hyperthyroidism is severe and untreated. The course of the disease may be mild, characterized by remissions and exacerbations, and terminate with spontaneous recovery in a few months or years. Conversely, it may progress relentlessly, with the untreated person becoming emaciated, intensely nervous, delirious, and even disoriented; eventually, the heart fails. Symptoms of hyperthyroidism may occur with the release of excessive amounts of thyroid hormone as a result of inflammation after irradiation of the thyroid or destruction of thyroid tissue by tumor. Such symptoms may also occur with excessive administration of thyroid hormone for the treatment of hypothyroidism. Long-standing use of thyroid hormone in the absence of close monitoring may be a cause of symptoms of hyperthyroidism. It is also likely to result in premature osteoporosis, particularly in women. Assessment and Diagnostic Findings https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IZN5n24G8UktHULazYLeTIBFBizuuh93swtew1H3xVYA2sj… 1/2 11/20/23, 1:06 AM Realizeit for Student The thyroid gland is enlarged to some extent. It is soft and may pulsate; a thrill often can be palpated, and a bruit is heard over the thyroid arteries (Norris, 2019). These are signs of greatly increased blood flow through the thyroid gland. In advanced cases, the diagnosis is made on the basis of the symptoms, a decrease in serum TSH, increased free T4, and an increase in radioactive iodine uptake. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IZN5n24G8UktHULazYLeTIBFBizuuh93swtew1H3xVYA2sj… 2/2