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Hyperthyroidism 19.7.08

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Hyperthyroidism 19.7.08

  1. 1. Hyperthyroidism dr shabeel’s presentations
  2. 2. Causes <ul><li>Grave’s disease </li></ul><ul><li>Multi-nodular goitre </li></ul><ul><li>Solitary nodule </li></ul><ul><li>Thyroiditis (de Quervain’s ) </li></ul>
  3. 3. Rare causes <ul><li>TSH induced </li></ul><ul><li>Follicular carcinoma </li></ul><ul><li>Iodide induced </li></ul><ul><li>Factitious </li></ul><ul><li>Extra thyroidal source ( struma ovary ) </li></ul>
  4. 4. Clinical features <ul><li>Goitre / bruit </li></ul><ul><li>Decreasing body weight </li></ul><ul><li>Normal / increased appetite </li></ul><ul><li>Increased frequency of stools </li></ul><ul><li>Palpitation – sinus tachy / AF </li></ul><ul><li>Angina / cardiac failure </li></ul><ul><li>DOE </li></ul>
  5. 5. Contd…… <ul><li>Nervousness </li></ul><ul><li>Irritability </li></ul><ul><li>Tremor </li></ul><ul><li>Hyper reflexia </li></ul><ul><li>Proximal myopathy </li></ul><ul><li>Increased sweating </li></ul><ul><li>Alopecia / Vitiligo </li></ul>
  6. 6. Contd……… <ul><li>Pretibial myxoedema </li></ul><ul><li>Amenorrhoea / oligomenorrhoea </li></ul><ul><li>Loss of libido / impotence </li></ul><ul><li>Lid retraction / lid lag </li></ul><ul><li>Chemosis </li></ul><ul><li>Exophthalmos / corneal ulcer </li></ul><ul><li>Ophthalmoplegia </li></ul><ul><li>Heat intolerance / fatigue </li></ul>
  7. 9. Investigations <ul><li>T3,T4 – increased </li></ul><ul><li>TSH – decreased / undetectable </li></ul><ul><li>TSH receptor antibodies – increased in Grave’s disease </li></ul>
  8. 10. Management <ul><li>Anti-thyroid drugs </li></ul><ul><ul><li>Carbimazole </li></ul></ul><ul><ul><li>Propylthiouracil </li></ul></ul><ul><li>Sub total thyroidectomy </li></ul><ul><li>Radio iodine </li></ul><ul><li>Beta blockers </li></ul>

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