Thyrotoxicosis
Aetiology
Clinical Features
Signs and Sx
T remor
H eart rate inc
Y awning (fatigued)
R estlessness
O ligomenorrhoea/ amenorrhoea
I ntolerance to heat
D iarrhoea
I rritability
S weating
M uscle wasting/ wt loss
Investigations
Bloods
Imaging
Management
Surgical risks
NOTE: Anti-thyroid drugs before surg to avoid thyroid storm. Must be euthyroid before surg
Complications
Source
OHCM 8th Ed
Toronto Notes 2012
- Graves disease (most common)
- Toxic multinodular goitre
- Toxic adenoma
- Ecopic thyroid tissue
- Iodine excess
Clinical Features
Signs and Sx
T remor
H eart rate inc
Y awning (fatigued)
R estlessness
O ligomenorrhoea/ amenorrhoea
I ntolerance to heat
D iarrhoea
I rritability
S weating
M uscle wasting/ wt loss
Investigations
Bloods
- TFT, ESR, CMP, LFT, TRAb (for Grave's), Anti-TPO, Anti-TG
Imaging
- US (distinguish cystic. solid), isotope scan (almost no hot nodules malignant)
Management
- Meds (Carbemazole, PTU for pregnant)
- Radioiodine
- Thyroidectomy
Surgical risks
- Superior/ recurrent laryngeal n damage (<1% perm/ 5% temp) --> sup = cricothyroid mm that helps sing/ shout
- Parathyroids
- Bleeding --> venous congestion --> resp distress
- Function (thyroid storm/ hypoTR)
- Scar
NOTE: Anti-thyroid drugs before surg to avoid thyroid storm. Must be euthyroid before surg
Complications
- Heart failure
- Angina
- AF
- Osteoporosis
- Ophthalmopathy
- Gynaecomastia
Source
OHCM 8th Ed
Toronto Notes 2012