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5 Cards in this Set

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Thyrotoxicosis: Clinical Presentation, Investigations, Hormone Abnormalities, Differential Diagnosis
1. Clinical Presentation: hyper but tired, difficulty concentrating, family Hx of autoimmune disease, hyper-reflexia, proximal muscle weakness, restlessness, rapid speech, weight loss, increased appetite, tachycardia, sweating, warm soft skin, exopthalmos, diploplia, goiter, tremor
2. Investigations: initially do sTSH, free T4, free T3, serum K+, ECG, betaHCG, CBC, if thyrotoxic then do radioactive iodine uptake(RAI) and thyroid stimulating immunoglobulin(TSI) tests
4. Hormone Abnormalities: high T3/T4+low TSH (primary), high T3/T4+high TSH(secondary)
5.Differential Diagnosis: high RAI uptake disease (Graves', multinodular goiter, toxic adenoma), low RAI uptake disease (subacute thyroiditis, exogenous thyroid hormone)
What is the differential diagnosis for feeling "hyper but tired"? (10)
anxiety, caffeine excess, drugs, drug withdrawal, hyperthyroidism, anemia, eating disorder, arrhythmia, pheochromocytoma, hypoglycemia
Thyroid Stimulating Immunoglobulin: Target, Effects, Correlation to Disease
1. Target: TSH receptor
2. Effects: goiter (stimulation of growth), hyperthyroidism (increased T3/T4 production), hypothyroidism (blocking T3/T4 production), orbitopathy (interacts with fibroblast receptors behind eye)
3. Correlation to Disease: correlates with disease activity
Graves' Disease: Pathophysiology, Treatment
1. Pathophysiology: autoimmune production of Thyroid Stimulating Immunoglobulins against TSH receptor
2. Treatment: Beta-blocker (symptoms), Thiouracil (first line), radioactive iodine (second line), surgery (third line)
Pathophysiology of Thyrotoxic Diseases: Multinodular Goitre, Toxic Adenoma
1. Multinodular Goitre: multiple benign nodules that make excess hormone, if cold could be cancerous
2. Toxic Adenoma: benign tumour that makes hormone independent of TSH