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Management of Thyroid Disorders .pdf


Original filename: Management of Thyroid Disorders.pdf
Title: Thyroid Disorders
Author: KHALID

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Thyroid Disorders

Prof A K M Musa
MBBS ,FCPS,MCPS .DTCD

Professor & Head of Medicine
BIRDEM & IMC

Introduction


Thyroid disorders:
– Hypothyroidism
– Hyperthyroidism and
thyrotoxicosis
 Graves’ disease
 Thyroiditis
 Toxic adenoma
 Toxic multinodular
goitre
 Thyrotoxicosis
factitia
 Struma ovarii

– Nontoxic goitre
– Thyroid nodules & thyroid

cancer
 Benign thyroid nodules
 Thyroid cancer
– Papillary carcinoma
– Follicular
carcinoma
– Medullary
carcinoma
– Anaplastic
carcinoma
– Lymphoma
– Cancer metastatic
to the thyroid

Hypothyroidism


Etiology:
– Primary:








Hashimoto’s thyroiditis with or without goitre
Radioactive iodine therapy for Graves’ disease
Subtotal thyroidectomy for Graves’ disease or nodular
goitre
Excessive iodine intake
Subacute thyroiditis
Rare causes
– Iodide deficiency
– Goitrogens such as lithium; antithyroid drug therapy
– Inborn errors of thyroid hormone synthesis

– Secondary: Hypopituitarism

– Tertiary: Hypothalamic dysfunction

(rare)
– Peripheral resistance to the action of
thyroid hormone

Hypothyroidism


Clinical features

– Cardiovascular

signs:
 Bradycardia
 Low voltage ECG
 Pericardial
effusion
 Cardiomegaly
 Hyperlipidemia









Constipation, ascites
Weight gain
Cold intolerance
Rough, dry skin
Puffy face and hands
Hoarse, husky voice
Yellowish color of skin
due to reduced
conversion of carotene to
vitamin A
– Respiratory failure
– Menorrhagia, infertility,
hyper- prolactinemia

Hypothyroidism
– Renal function:

Impaired ability to
excrete a water load
– Anemia:
 Impaired Hb
synthesis
 Fe deficiency due to:
– Menorrhagia
– Reduced
intestinal
absorption
 Folate def. due to
impaired intestinal
absorption
 Pernicious anemia


– Neuromuscular system:

Muscle cramps,
myotonia
 Slow reflexes
 Carpal tunnel
syndrome
– CNS symptoms:
 Fatigue, lethargy,
depression
 Inability


Congenital Hypothyroidism

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