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Hyperthyroidism Diagnosis and Management

The patient, a 45-year-old lady, presented with complaints of nervousness. On examination, she was found to be restless, tachycardic with an irregular pulse, and exhibited signs of hyperthyroidism including lid lag, lid retraction, exophthalmos, and a warm, sweaty skin with fine tremors. Laboratory tests showed elevated levels of T3 and T4 and a suppressed TSH, confirming the diagnosis of hyperthyroidism. The doctor provided an explanation of the condition, noting that an overactive thyroid gland can cause symptoms like fatigue, nervousness, and weight loss. Treatment options including radioactive iodine therapy, antithyroid medications, or surgery were discussed.

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76 views1 page

Hyperthyroidism Diagnosis and Management

The patient, a 45-year-old lady, presented with complaints of nervousness. On examination, she was found to be restless, tachycardic with an irregular pulse, and exhibited signs of hyperthyroidism including lid lag, lid retraction, exophthalmos, and a warm, sweaty skin with fine tremors. Laboratory tests showed elevated levels of T3 and T4 and a suppressed TSH, confirming the diagnosis of hyperthyroidism. The doctor provided an explanation of the condition, noting that an overactive thyroid gland can cause symptoms like fatigue, nervousness, and weight loss. Treatment options including radioactive iodine therapy, antithyroid medications, or surgery were discussed.

Uploaded by

jljoioiu
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd

HYPERTHRYROIDISM PE: GA BMI, weight of the patient

A 45 YEARS OLD LADY CAME TO YOUR GP CLINIC Is the patient restless or agitated?
COMPLAINING OF NERVOUSNESS VS Pulses irregular, tachycardic, AF
TASK: HISTORY Eyes: lid lag, lid retraction, exophthalmos,
PE FINDING FROM EXAMINER ophthalmoplegia
INVESTIGATIONS AND MANAGEMENT Neck and lymph node: thyroid
February 2008 Melbourne Palpation, auscultation
Skin: warm sweaty, fine tremor +
Differential Proximal myopathy, reflexes
Panic Attacks Cardiovascular +systolic murmur could be present in this
Perimenopausal symptoms patient
Psychotic problems Pemberton’s sign

History: Investigation: T3, T4 TSH


Have you noticed any changes in your behaviour? Any Radio isotope scan
irritability?
How long have you been experiencing this? Explanation
Is there anything that you are worried about that causes Your condition, thyroid gland – gland in the neck – it
you anxiety? produces a hormone called thyroxine which is
Are you anxious most of the time? responsible for all cells in the body. – control the
Any stress or problem at home? metabolism rate of our body – control the energy
Any stress in your job? expenditiure of the cell
If the action of the thyroid gland is higher the more
How is your appetite? Good no problem symptoms you will have like tiredness, nervousness and
Sleep? What is your sleep like? I can t go to sleep,it is weight loss
lesser than before Refer to specialist he may do
Do you wake up early morning – no What is the treatment: Radioactive Iodine 131 therapy
Any change in weight? + loss of weight Drug therapy : propylthiouracil (thionamide), beta blocker,
How much in how many months? carbamizole
Any pain in the body? Surgery: subtotal or total thyroidectomy
Do you feel feverish or hot?
Do you sweat a lot? Yes in my hands Causes: grave’s disease – autoimmune – do antibodies
Do your hand shake? Or have tremors Solitary nodule ademoma
De Quervain’s Thyroiditis
Do you have shortness of breath, cough, Iodine excess
Palpitation? Yes Medication: amiodarone
How are your bowel motions? Very loose 3-4 times a day Refer for treatment
Waterwork? No problem

How are your periods? Irregular


Any weakness?

General health of patient before?


Any exposure to radiation?
Past history of thyroid disease or surgery?
Any surgery in the neck?
DM?
Past history of psychiatric problem
Family history of thyroid? Autoimmune disease?
Malignancy? Any chronic diseases

Medication – amiodarone can cause hyperthyroidism


SAD

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