Cindy Blacketer

I.

Hyperthyroidism
A. B. Hyperactive thyroid gland Hyper excretion of thyroid hormone

II.

Risk factors & Sources

A. Risk factors
1. 2. 3. 4. 5. More common in women Usually occurs between the ages of 20-40 Presents after extreme stress or pregnancy Prior thyroid problems Have pernicious anemia; type 1 diabetes; or primary

adrenal insufficiency 6. 7. Family history of thyroid disease Consuming large amounts of food containing iodine

B.

Sources
1. Hyperactive thyroid gland

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2. Graves disease a) Causes antibodies that mistakenly stimulates

thyroid production 3. Toxic Nodular/Multi-nodular goiter a) Enlarged thyroid gland characterized by numerous

nodules and hyper secretion of thyroid hormones 4. Thyroiditis a) Inflammation of thyroid gland (1) Viral infection causes gland to leak thyroid

hormone 5. Secondary hyperthyroidism a) Pituitary gland overrides thyroids normal

instructions 6. Overmedicating with synthetic hormone for

hypothyroidism

III.

Explanation, Sign & Symptoms

A. Explanation of Hyperthyroidism
1. The thyroid gland produces hormones

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a) b) 2. (TSH) a) 3. Produced by the pituitary gland Thyroxine (T4) Triiodothyronine (T3)

Production is controlled by thyroid-stimulating hormone

Overproduction of thyroid hormones by an overactive

thyroid gland a) 4. 5. Despite production of TSH

Located in the anterior of the neck Excessive hormones in blood increase bodies metabolism

B.

Signs
1. 2. 3. 4. 5. 6. 7. 8. Accelerated metabolic process Tachycardia Cardiac palpitations Dyspnea Goiters Diaphoresis Exophthalmos Tremors 3

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9. 10. 11. 12. 13. Weight loss Hypertension Pyrexia Diarrhea Occasional thickening of skin on back of hands, back,

feet and face 14. Changes in menstrual periods

C.

Symptoms
1. 2. 3. 4. 5. 6. 7. Anxiety Increased appetite Insomnia Possible delirium Heat intolerance Agitation Nervousness

IV.

Diagnostic test & labs for diagnosing

A. Diagnostic Test
1. Physical examination 4

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a) b) 2. Thyroid size Fingers tremor

Thyroid ultrasound a) Checking for size, shape, position, & growths

3.

Thyroid scan a) b) Nuclear scan Checks for size shape, position & physiologic

function

B.

Labs
1. Blood test for elevated TSH, T3 and T4 levels a) T3 = triiodothyronine (1) b) Average adult levels = 70-250 ng/dL

T4 = thyroxine (1) Average adult levels = 0.8-2.8 ng/dL

c)

TSH = thyroid stimulating hormone (1) Adult average levels = 2-10mU/L

2.

Radioactive iodine uptake test a) with 5 Average findings are increased thyroid function

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administration of exogenous TSH

V.

Treatments of Hyperthyroidism
A. Radioiodine therapy
1. 2. 3. Calms thyroid production Thyroid become underactive Underactive thyroid is permanent in 50% of patients a) Hypothyroidism

B.

Medications
1. 2. Beta Blockers Antithyroid a) b) Methimazole Propylthiouracil

C.

Surgery
1. Ablation of thyroid gland

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VI.

Complications of Hyperthyroidism
A. Graves Disease
1. An autoimmune disease triggered by hyperthyroidism

B.

Thyroid Crisis
1. 2. Uncontrolled thyrotoxicosis Can result in death

C. D. E.

Higher risk for Osteoporosis Congestive Heart Failure Surgery complications

1. 2. 3. Scarring on neck Damage to voice box Low calcium levels

VII. Prognosis of Hyperthyroidism

A. B. C. Treatable Rarely life threatening Can cease without treatment

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D. E.

Treatments can lead to hypothyroidism Graves disease

1. 2. 3. Worsens over time Severe complications Effects quality of life

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Bibliography

Hyperthyroidism. Mosbys dictionary of medicine, nursing, & health professions. (8 ed., pp. 819, 915, 1846-1847, 1865). St Louis, MO: Mosby Elsevier. Pagana, PhD, RN, K., & Pagana,MD,FACS, T. (2011). Mosbys diagnostic and laboratory test reference. (10 ed., pp. 946-977). St Louis, MO: Mosby Elsevier. Braverman, MD, L. National endocrine and metabolic disease information services, U.S. Department of Health and Social Services. (2008). Hyperthyroidism (NIH Publication No. 08-5415). Bethesda, MD: National endocrine and metabolic disease information services. Retrieved from http://endocrine.niddk.nih.gov/pubs/Hyperthyroidism/ Eckman, MD, A. National Library of Medicine, National Institutes of Health. (2011). Hyperthyroidism, overactive thyroid. Bethesda, MD: A.D.A.M. Medical Encyclopedia. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001396/
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