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Thyroid disorders (Hyperthyroidism (Pathophysiology (Increase in thyroid…
Thyroid disorders
Hyperthyroidism
Pathophysiology
Increase in thyroid hormone
Contingent on cause
Primary: Graves disease: Suppressed TSH
Secondary: TSH secreting pituitary adenoma
Tertiary: Hypothalamic disease with significant increase in TRH production
Epidemiology
90% prevalent is Graves Disease
The body produces too much thyroid hormone
Most common: The thyroid receptor antibody promotes the thyroid follicular cells to generate additional quantities of T4 and T3.
Less often: Multinodular goiter from goiter iodine or TSH regulation which produces too much T 3 and T4
Rare: TSH overproduction triggering increase in thyroid hormone production
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Treatment
Elevated TH and decreased TSH and radioactive iodine uptake scan. Antithyroid medications, radioactive iodine therapy, and surgery
Thyrotoxic crisis: propylthiouracil, beta-blockers, steroids, iodine, supportive care
Hypothyroidism
Epidemiology
Primary: Affects 3.5 per 1000 women versus 0.8 per 1000 men. Gradual Inflammatory damage to thyroid tissue by permeation of T lymphocytes and antibodies
Rare: Secondary hypothyroid related to pituitary or hypothalamus failure
Pathophysiology
Loss of thyroid function
Primary: Decreased production of Thyroid hormone and increased level of TSH
Secondary: Pituitary failure associated with tumors or surgery
Clinical Manifestations
Puffy face
Decreased heart rate
weight gain
constipation
muscle weakness
extremity swelling
cold intolerance
Diagnosis and Treatment
Increased levels of TSH and Decreased levels of total T3 and free T4
Hormone replacement therapy~ levothyroxine preferred
References
Huether, S. E., & McCance, K. L. (2017). Understanding Pathophysiology (6th ed.). St. Louis, MO: Elsevier.