Topic 6 of 74 in the MU Plovdiv syllabus for Special Surgery (Medicine, Year 4). The free AceMed note covers it in 15 sections, about 992 words (8 min of reading), with 13 flashcards.
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THEME II: THE THYROID GLAND: Thyrotoxicosis (Graves’ Disease), Solitary toxic Adenoma, Hashimoto’s Thyroiditis, Non-Toxic Goiter, Carcinoma of the Thyroid Gland.
What is the definition of “Graves’ disease”?
What is the classic triad of Graves’ disease presentation?
What does the diagnosis of Graves’ disease include?
What does “thyrotoxic crisis” mean?
There are three main treatment modalities for Graves’ disease. Which are they?
What are the advantages of surgical treatment of Graves’ disease?
What is the definition of “toxic adenoma”?
Which are the indications for radioscintigraphy of the thyroid gland disorders?
What is the treatment of toxic adenoma?
Pathophysiology of Graves disease? (other source)
Indications of operative treatment for Graves disease? (other source)
Thyrotoxicosis
Graves and Hashimotos
36) Toxic adenoma
THEME II: THE THYROID GLAND: Thyrotoxicosis (Graves’ Disease), Solitary toxic Adenoma, Hashimoto’s Thyroiditis, Non-Toxic Goiter, Carcinoma of the Thyroid Gland.
1. What is the definition of “goitre”?
Goiter refers to an enlarged thyroid gland (From the Latin guttur meaning throat).
For clinical practice “enlargement” is taken to mean a thyroid gland that is easily visible or palpable with the neck in neutral position.
Goitres result from follicular cell hyperplasia at one or multiple sites within the thyroid gland.
2. What is the cause of endemic non-toxic goitre?
Endemic non-toxic goitres are caused by dietary iodine deficiency (less than 100 mg/day).
The worldwide geographical distribution of endemic goitre corresponds closely to alpine areas where glacial action has leached iodine from the soil and carried it away to the sea: endemic goitres are rarely seen in coastal areas.
3. What are the clinical features of non-toxic goiters?
Initially, the non-toxic goitre is euthyroid, but with increasing size, elevations in T3 and T4 levels can occur and gradually progress to clinical hyperthyroidism.
In endemic areas the lack of sufficient iodine intake results in a large proportion of hypothyroid conditions.
Growth of the goitre may cause compressive symptoms:
Dyspnoea (worse when lying flat) due to tracheal displacement
Dysphagia due to esophageal compression
Voice changes due to recurrent laryngeal nerve pressure.
4. Which are the classic symptoms of hyperthyroidism?
Classic symptoms of hyperthyroidism or thyrotoxicosis include
Sweating
Unintentional weight loss despite increased appetite
Heat intolerance
Sleep disturbance
More severe signs of thyrotoxicosis
High output cardiac failure
Congestive heart failure with peripheral edema
Arrhythmias such as ventricular tachycardia and atrial fibrillation.
Increased thirst
Menstrual disturbance
Anxiety
Hairloss
Diarrhoea
Palpitations
5. Which are the three commonest causes of hyperthyroidism?
Graves’ disease
Toxic multinodular goitre
Solitary toxic adenoma
These are the three commonest causes of hyperthyroidism.
HYPERTHYROIDISM SYMPTOMS
FATIGUE
WEIGHT LOSS
SENSITIVITY TO COLD
DEPRESSION
MEMORY PROBLEMS
GOITER
HAIR LOSS
MUSCLE PAIN
TREMBLING HANDS
INFERTILITY
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