Hyperthyroidism is caused by conditions like Graves' disease, multinodular goiter, solitary nodules, and thyroiditis. Rare causes include TSH-induced hyperthyroidism and follicular carcinoma. Clinical features include goiter, weight loss, increased appetite, diarrhea, palpitations, angina, dyspnea, nervousness, tremors, and increased sweating. Investigations show increased T3 and T4 levels with decreased or undetectable TSH, and increased TSH receptor antibodies in Graves' disease. Management involves anti-thyroid drugs, surgery, radioactive iodine, and beta blockers.

1. Hyperthyroidism dr shabeel’s presentations

2. Causes Grave’s disease Multi-nodular goitre Solitary nodule Thyroiditis (de Quervain’s )

3. Rare causes TSH induced Follicular carcinoma Iodide induced Factitious Extra thyroidal source ( struma ovary )

4. Clinical features Goitre / bruit Decreasing body weight Normal / increased appetite Increased frequency of stools Palpitation – sinus tachy / AF Angina / cardiac failure DOE

5. Contd…… Nervousness Irritability Tremor Hyper reflexia Proximal myopathy Increased sweating Alopecia / Vitiligo

6. Contd……… Pretibial myxoedema Amenorrhoea / oligomenorrhoea Loss of libido / impotence Lid retraction / lid lag Chemosis Exophthalmos / corneal ulcer Ophthalmoplegia Heat intolerance / fatigue

9. Investigations T3,T4 – increased TSH – decreased / undetectable TSH receptor antibodies – increased in Grave’s disease

10. Management Anti-thyroid drugs Carbimazole Propylthiouracil Sub total thyroidectomy Radio iodine Beta blockers