Graves’ Risk is increased

Other eye and facial signs

Disease with smokers

Exophthalmos

Patients with high TSI also Edematous swelling of

Thyroid gland Production of retro-orbital tissues &
Thyroid-Stimulating have high concentration of Eye muscles Ophthalmopathy Von Graefe’s sign
Bone marrow degenerative changes in
Immunoglobulins (TSI) immunoglobulins that react
Lymph node extraocular muscles
with:

stimulate Thyroid Dermopathy Warm and moist skin, Sweating and heat intolerance
Skin & Hair
Skin Clubbing Palmar erythema, Onycholysis, Pruritus, Urticaria, and
(+) TRAbs Diffuse hyperpigmentation, Fine hair, Diffuse alopecia
TSH Receptors

Sexual function Impotence, Oligomenorrhea or Amenorrhea(rare)

Increased uptake Thyroid Hormone Production Increased T3 and CNS effects ↑ neuronal synapse
Fine muscle tremors
of Iodine T4 production reactivity

Iodine Trapping ↑ metabolism

↑ Excitability and Constant feeling of tiredness but have
Negative Irritability difficulty sleeping
Thyroid Scan
Formation and Secretion feedback
of Thyroglobulin
↑ O₂ and nutrient ↑Protein synthesis Glucose absorption Decreased GI transit time,
demand Gluconeogenesis increase stool frequency with ↑ Appetite
Oxidation of Iodide Glycogenolysis diarrhea
Decreased TSH
secretion

Organification of
Thyroglobulin Cardiovascular
Thyroid Function Tests: effects Weight loss Despite
↑ FT4
Storage of ↑ FT3
Thyroglobulin ↓ TSH
↑ Cardiac output
Release of Free T3 ↑ Heart rate (+) Atrial Fibrilation Warfarin
and T4 ↑ heart strength
Diffusely enlarged thyroid ↑ RR
(+) Thyrotoxic State Digoxin
gland with uniformly increased Deiodination of T4 → T3
uptake
Managed with

inhibits Propranolol (20-40 mg q6h)

Propylthiouracil (100-200
mg q6-8h)
Increased vascularity
May cause Hepatitis(rare) around thyroid gland

(+) bruits over thyroid gland

Managed with

Antithyroid Drugs Methimoxazole (15-40mg QD)

May cause Cholestasis(rare)

Common Side Other rare Side

Effects Effects

Rash Vasculitis
Urticaria Agranulocytosis
Fever
arthralgia