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Hypercalcaemia
is needed in many other enzymes as co-factor : ECF calcium concentration are maintained within a narrow range by feedback mechanisms that involve PTH and Vit D, which integrate signals btw the parathyroid glands, kidneys, intestines and bone. ↓ECF Ca2+ → ↑PTH secretion (1) PTH → ↑increased tubular reabsorption of…
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Hyperthyroidism
Thyroid Hormone Regulation Functions of Thyroid Hormone Hyperthyroidism Hyperthyroidism is characterized by an excessive concentration of thyroid hormones in tissues, caused by increased synthesis, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. Aetiology of Hyperthyroidism Common Causes Graves’ Disease Pathophysiology Treatment Signs of Graves’ Disease…
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Hypothyroidism
AETIOLOGY Clinical Features Appearance Puffy and pale faciesDry, brittle hairSparse eyebrowsDry, cool skinThickened and brittle nailsMyxoedema – fluid infiltration of tissues Energy and nutrient metabolism Cold intoleranceWeight gainFatigue Nervous system HeadacheParaesthesias (including carpal tunnel syndrome)Cerebellar ataxiaDelayed relaxation of deep tendon reflexes Cognitive/ psychiatric Reduced attention spanMemory deficitsDepression Cardiovascular BradycardiaDiastolic hypertensionPericardial…
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Parathyroid disease
Hyperparathyroidism three types of Hyperparathyroidism [CKD → impaired renal phosphate excretion → ↑ phosphate blood levels→ ↑ PTH secretion] [CKD → ↓ biosynthesis of active vitamin D → ↓ intestinal calcium resorption and ↓ renal calcium reabsorption → hypocalcemia → ↑ PTH secretion] Other: Presentation Hypoparathyroidism (failing parathyroid function or…
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Thyroid – anatomy & function
Thyroid Hormone Regulation and Metabolism Active and Inactive Forms of Thyroid Hormones Function: Effects on Foetal Development Effects on Oxygen Consumption, Heat Production and Free Radical Formation Cardiovascular Effects Sympathetic Effects Pulmonary Effects Haematopoeitic Effects Gastrointestinal Effects Skeletal Effects Neuromuscular Effects Effects on Lipid and Carbohydrate Metabolism Endocrine Effects Other…
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Thyroid disease in pregnancy
AFP – Thyroid disease in the perinatal period http://www.racgp.org.au/afp/2012/august/thyroid-disease-in-the-perinatal-period/ Etg therapeutic guidelines – thyroid disorders and pregnancy Hypothyroidism Management Hyperthyroidism Management TSH Measurement Recommendations Iodine Supplementation Isolated Hypothyroxinaemia
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Thyroid Nodules and Cancers
Thyroid nodules are often picked up as incidental findings on clinical examination, or on imaging (usually carotid ultrasound) for another purpose. They can cause problems if they become large and compress the oesophagus / trachea. Causes of clinically detectable thyroid nodule: History Workup Treatment and Followup FNA Results FNA results…
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Thyroid storm
Precipitants of Thyroid Storm Pathophysiology Clinical Manifestations Organ System Symptoms Signs CNS Anxietyconfusiondelirium Hyperreflexiaseizurescoma psychosis, lethargy Cardiovascular Palpitationschest paindyspnoea Sinus tachycardiaatrial fibrillation on exertion widened pulse pressureheart failure Gastrointestinal Abdominal painnauseavomiting Diarrheajaundice diarrhea Thyroid Gland Neck fullness Tendernessdiffuse enlargementbruit Diagnosis Management Basics Disposition Take Home Points