2. Contents
• Objectives
• Physiology of Thyroid gland
• Introduction of Hypothyroidism
• Clinical features of Hypothyroidism
• Investigations of Hypothyroidism
• Introduction of Hyperthyroidism
• Clinical features of Hyperthyroidism
• Investigations of Hyperthyroidism
• Summary
• Conclusion
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3. Objectives
By the end of the presentation the students must
be able to-
1. Discuss Physiology of Thyroid gland
2. Explain Introduction of Hypothyroidism
3. Enumerate Clinical features of
Hypothyroidism
4. State Investigations of Hypothyroidism
5. Explain Introduction of Hyperthyroidism
6. Enumerate Clinical features of
Hyperthyroidism
7. State Investigations of Hyperthyroidism
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6. Synthesis &
Metabolism
• Iodine enters thyroid gland and is used for T3 and T4
production
• Hormones are released from the thyroid and vast
majority are protein bound (TBG) and deposited in
peripheral cells
• T4 has 4 iodine atoms, removal of one produces T3
Total= Bound to TBG
Free= Unbound
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7. Cont…
T3 &T4
• Facilitate normal growth and development
• Increase metabolism
• Increase catecholamine effects
TSH
• Most useful marker of thyroid hormone function
• Released in a pulsatile diurnal rhythm- highest at
night
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15. Clinical features
of
Hyperthyroidism
• Recent weight loss
• Increased appetite
• Increase in # BM/day
• ****heat intolerance
• Diaphoresis even when temperatures
comfortable for others
• Palpitations/chest pain
• Dyspnea with or without exertion
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16. Cont…
• Infiltrative Ex ophthalmopathy (abnormal eye
appearance or function)
• Blurring/double vision/tiring of eyes
• Increased tears
• Photophobia
• Eyelid retraction(eyelid lag)
• Globe lag (eyeball lag)
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17. Goitre
• Thyroid gland may be 4 X normal
• Bruits (turbulence from increased blood flow)
heard with stethoscope
• Systolic BP
• Tachycardia
• Dysrhythmia
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19. Investigations of Hyperthyroidism
• T3
• T4
• TSH in Graves disease
• Radioactive Thyroid Scan
• Ultrasonography: used to determine goiter or nodules
• EKG: note tachycardia
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20. Summary
Physiology of Thyroid
gland
Introduction of
Hypothyroidism
Clinical features of
Hypothyroidism
Investigations of
Hypothyroidism
Introduction of
Hyperthyroidism
Clinical features of
Hyperthyroidism
Investigations of
Hyperthyroidism
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21. References • Davidson Principles Of Medicine & Practice Of
Medicine .20th Ed
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