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HYPERTHYROIDISM - Coggle Diagram
HYPERTHYROIDISM
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Clinical Presentation
Palpitations, tachycardia
Nervousness, anxiety, irritability
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Menstrual irregularities (e.g., oligomenorrhea)
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Pathophysiology
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Autoimmune forms (e.g., Graves’ disease): TSH receptor antibodies stimulate the thyroid gland.
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Increased bone turnover, cardiac output, GI motility, and nervous system excitability.
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Investigations
Radioactive iodine uptake scan: Diffuse uptake in Graves’, focal in toxic nodules
ECG: Sinus tachycardia, atrial fibrillation
Thyroid autoantibodies: TSH receptor antibodies (TRAb) – Graves', Anti-TPO and anti-thyroglobulin (less specific)
Thyroid ultrasound: Assess size, vascularity, and nodules
Thyroid function tests: low TSH, high free T4 & T3
Treatment
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Thyroidectomy: Indicated for large goiters, malignancy, or intolerance to meds
Beta-blockers: Symptom control (e.g., propranolol)
Supportive care: Rehydration, nutrition, anxiety management
Antithyroid medications: Methimazole (first-line), Propylthiouracil (PTU) – preferred in pregnancy (1st trimester)
Examination
Skin: Warm, moist, smooth skin; onycholysis; pretibial myxedema (Graves')
Eyes: Lid lag, lid retraction, exophthalmos (Graves’ ophthalmopathy)
Vitals: Tachycardia, high systolic BP, wide pulse pressure
Thyroid: Diffuse, non-tender goiter ± bruit (in Graves’)
Neuromuscular: Fine tremor, brisk reflexes, proximal muscle weakness
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Prevention
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Monitor thyroid function in high-risk groups (e.g., postpartum women, patients on amiodarone).
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Risk Factors
Iodine exposure (e.g., contrast agents, supplements)
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Other autoimmune disorders (e.g., Type 1 diabetes)
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