Hyperthyroidism (most common cause is Graves dx)
Ophthamopathy(only in Graves)
hyperthyroid sympoms : wt loss , tremors, heat intolerance, diarrhoea, palpitations, menstrual irregularities, bruit over goitre, may have pretibial myxedema , proximal muscle weakness (can occur in both hypo and hyper) etc.
High T3, T4, low TSH (primary hyperthyroidism)
High radioiodine uptake (same for toxic nodule)
- Propanolol or Atenolol
- Propylthioracil or methimazole
- Radioactive iodine (kill the thyroid)
- thyroid replacement therapy
proptosis may worsen with tmt
Agranulocytosis may occur with PTU or Methimazole, monitor wbc.
if patient c/o fever, sorethroat etc while on tmt, stop meds and check wbc count
The agranulocytosis is reversible
Acute phase: low dose propanolol + low dose PTU. Do not use Methimazole in pregnancy
Definitive: Surgery in 2nd trimester. Do not use radio iodine in pregnancy