For medical education

1. By ; Dulsara Gunawardana - 301A’ (10.12.2020)
Teacher : Elena Vasilevna
Path physiology of Hyperthyroidism

2. Hyperthyroidism is abnormal condition of the body , which occurs when
your thyroid gland produces too much of hormone thyroxine
It can cause make toxicity in blood so called “Thyrotoxicosis”

3. Chemical structure of
Thyroid hormones are two hormones produced and released by thyroid gland
namely Triiodothyronine (T3)
Thyroxine (T4)
They are tyrosine based hormones

4. It’s increase the metabolism
Increase the activity of sympathetic nervous system
So when highly increase synthesis of thyroxine hormone , it can lead
Overactivity of sympathetic nervous system and highly increase of basal metabolism rate
It is the development of “Hyperthyroidism “

5. Myasthenia Gravis disease
Toxic multi modular goiter
Excessive intake of thyroid hormone
Inflammation of thyroid gland
Excessive intake of iodine

6. Increase cardiac output
Increase cotractility
Occur tachycardia
Palpitation of heart
Cardiomegaly
Arrhythmia s
Particularly arterial fibrilization ( it’s rare case of older patients)

7. In cardiac myocytes , lymphocytic and eosinophilia infiltrations
Fatty changes in myofibrils
Increase the size and numbers of myocites
In some peoples’ thyrotoxicosis develop reversibly , it can lead
left ventricular dysfunction and heart failure
(It’s so called thyroid or hyperthyroid cardiomyopathy)
Also in cvs increase peripheral oxrygen requirements

8. Overactivity of sympathetic nervous system lead
Tremor
Hyperactive state
Emotional lability
Anxiety
Inability to concentrate
Insomnia

9. Hypermotility of the track
Diarrhea
Weight lose due to malabsorption
Increase appetite

10. Decrease the muscle mass ( thyroid myopathy)
Atrophy of the skeletal muscles with fatty and focal interstitial lymphocytic
infiltration
Weakness of muscle

11. Thyroid hormone stimulates bone resorption
Increaseporosity of cortical bone and reducing the volume of
trabecular bone
Osteoporosis due to violations of calcium metabolism
High risk with bone fractures

12. Soft , warm ,fluished skin ( due to increase peripheral
blood flow and vasodilation then heat lose)
Increase sweating
Increase humidity

13. A wide staring gaze and lid lag are present because of
sympathetic overstimulation of the learterpalpebrae
superioris . How ever , true thyroid ophthalmopathy
associated with proposes is seen only in Gravis disease

14. Minimal liver enlargement due to fatty acid changes in hepatocytes
And
Patient with Gravis Disease have generalizedlymphoid hyperplasia and
lymphadenopathy
N.B. : Gravis Disease (Myasthenia Gravis) is a long term neuromuscular disorder
that leads to skeletal muscle disorders. The most commonly affected muscles are
those of the eyes , face , and swallowing . It can lead double vision , drooping
eyelids , trouble talking and trouble walking.

15. Thyroid function test
TSH test (normal value : 0.5 - 1.5 mU/L)
Thyroxine test ( normal value : 5 -12 mug/dL)
Tri iodothyorine test
And also we can do ECG