Aetiology:
- Graves
- toxic nodule - multinudular/single adenoma
- idiopathic - overtreatment of hypothyroid (post thyroidectomy)
- carcinoma
- TSH secreting tumour
Graves disease:
eye signs
- 75% grave have eye signs
proptosis - retrorbital tissue swelling
lid retraction - thyroixine action of orbital muscles
orbital oedema
treatment
propylthiouracil, carbimazole - Pro: reversible. Con: side effect
radioactive iodine - Pro:easy, cheap. Con: social isolation
surgery - Pro:effective, Con: risks, post-op hypothyroidism
Thyrotoxic cisis
- sudden infection to thyroid causing breakdown of cells and release of thyroxine
- iatrogenic overdose
Sx: fever, tachycardia, diarrhoea, jaundice, CNS symptoms
Mx: organ support, fluid balance, propylthiouracil, lugo's iodine (decrease thyroid vascularity)
