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Hypert hyroidi smClick to edit Master subtitle style Submit Sir Kim P. Suan, Hyperthyroidism ted to: RN Submitt Kristine Charisse V. ed by: TanedoBS-Nursing IMCC5/31/12

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Clinical Instructor

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INTRODUCTIO NHypert hyroidis mHyperthyroidism 5/31/12

Descr iption

INTRODUCTI ONHyperthyroid ism

Hyperthy roidism,The over secretion of thyroid hormones leads to over activity of the body's metabolism.5/31/12 33 Hyperthyroidism

Descr iption

INTRODUCTI ONHyperthyroid ism

Hyperthyroidism results from an excessive output of thyroid hormones due to abnormal stimulation of the thyroid gland by circulating immunoglobulin.

The condition is often referred to as an "overactivethyroid.Hyperthyroidism 5/31/12 44

Descr iption It

INTRODUCTI ONHyperthyroid ism

Thyroid hormone is important at a cellular level, affecting nearly every type of tissue in the body. functions as a stimulus to metabolism, and is critical to normal 2 Thyroid Hormones function of the cell.o

Thyroxine (T4) represents 90% of thyroid hormone production 5/31/12 Hyperthyroidism 55

1.) Graves' disease (Diffuse Graves' disease is most often associated Toxic Goiter)

Typ es

INTRODUCTI ONHyperthyroid ism

with hyperthyroidism. Researchers believe Graves' disease is caused by an antibody which stimulates the thyroid too much. This overstimulation causesthe excess production of thyroid hormone.

Graves'

disease is categorized as an autoimmune disorder (a dysfunction of the body's immune system). The disease66 is 5/31/12 Hyperthyroidism

1.) Graves' disease (Diffuse Symptoms of Toxic Goiter)Graves' disease are identical

Typ es

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to hyperthyroidism, with the addition of three other symptoms. However, each individual may experience symptoms. differently The three additional symptoms include: Goiter (enlarged thyroid which may cause a bulge in the neck) Exopthalmus (bulging of eyes) Dermopathy 5/31/12 Hyperthyroidism 77

INTRODUCTI ONHyperthyroid ism

dermopathy

Hyperthyroidism

Graves' disease (Diffuse Toxic Goiter)5/31/12

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2.) Toxic Nodular Goiter Hyperthyroidism caused (Multinodular Goiter) by toxic nodular

Typ es

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Hyperthyroidism

goiter is a condition in which one or more nodules of the thyroid becomes overactive. The overactive nodules actually act as benign thyroid tumors. Symptoms of toxic nodular goiter do not include bulging eyes or skin problems, as in Graves' disease. The cause of toxic nodular goiter is not known5/31/12 99

3.) Thyroiditis Thyroiditis

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causes temporary hyperthyroidism, usually followed with hypothyroidism (an underactive thyroid).

Thyroiditis is an inflammation of the thyroid gland. 5/31/12 Hyperthyroidism

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3.) Thyroiditis

There are three types of thyroiditis: Hashimoto's thyroiditis Subacute granulomatous thyroiditis Silent lymphocytic thyroiditis

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In addition, if a person takes too many thyroid hormone tablets, 5/31/12 Hyperthyroidism

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Incidence & Prevalence

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Relatively common disease that can occur at any age

More common in the 3rd and 4th decade Disease is more frequent in women(7:1)Hyperthyroidism 5/31/12 12

Incidence & Prevalence

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Genetic factors play an important role

An overlap exists with other autoimmune diseases suggesting Graves is also a autoimmune thyroid disease

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Prevalence Rate

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As expected, hyperthyroidism is 10 more common in females than in 8 males 6 (P< 0.001 in all 4 four periods). 2 A 3540% 0 increase in Hyperthyroidism

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Anatomy & physiology

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Hyperthyroidism

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Anatomy & physiology Hyperthyroid

ism

The thyroid is one of the largest endocrine glands in the body. This gland is found in the neck inferior to (below) the thyroid cartilage (also known as the Adam's apple in men) and at approximately the same level as the cricoid cartilage. The thyroid controls how quickly the body burns energy, makes proteins, and how sensitive the body should be to other hormones.Hyperthyroidism

Thyroi d Gland5/31/12 16

Anatomy & physiology Hyperthyroid

ism

The thyroid participates in these processes by producing thyroid hormones, principally thyroxine (T4) and triiodothyronine (T3). These hormones regulate the rate of metabolism and affect the growth and rate of function of many other systems in the body. Iodine is an essential component of both T3 and T4. The thyroid also produces the hormone calcitonin, which plays a role in calcium homeostasis.Hyperthyroidism

Thyroi d Gland5/31/12 17

Anatomy & physiology Hyperthyroid

ism

The thyroid is controlled by the hypothalamus and pituitary. The gland gets its name from the Greek word for "shield", after the shape of the related thyroid cartilage. Hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) are the most common problems of the thyroid gland.Hyperthyroidism 5/31/12 18

Thyroi d Gland

Anatomy & physiology Hyperthyroid

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A normal adult thyroid gland usually weighs 10 to 20 g. It receives its nourishment from bilateral superior and inferior thyroid arteries and a small artery called thyroid ima.

Thyroi d Gland5/31/12 19

Hyperthyroidism

Anatomy & physiology Hyperthyroid

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pathophysiology

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pathophysiologyOf Thyroi Hyperthy d roidism Gland

Predisposing factors: Sex Age

Precipitating factors: Diffuse toxic goiter (Grave's dse.) Autoimmune Condition secondary to: stress, crisis or infection Tobacco smoking

Thyroid Hormone (T3, T4) due to Immune Reactivity to TSH Receptor (Graves Disease)

Specific Immune Response/ Autoimmune Infiltration of Lymphocytic, Mucopolysaccharides, Fluid, Glycosaminoglycans

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pathophysiologyOf Hyperthy roidism Fluid retention in Retrobulbar Soft Tissue, Extra-ocular Muscle Pressure to Optic Nerve Blindness Bulging of Eyes Proptosis/ Exophtalmu s Lid Lag

Diplopia

Lid Retraction

Corneal Exposure

Dryness of Corneal

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Irritation of Eyes

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Diagnostic procedures

Hyperthyroid ism

In addition to a complete medical history and medical examination, diagnostic procedures for hyperthyroidism may include: v Measurement of thyroid hormone in the bloodstream v Thyroid ultrasound A test to evaluate the thyroid gland for evidence of any nodules. v Thyroid scan A test that uses a radioactive substance to create an image of the thyroid.Hyperthyroidism 5/31/12 24

What are the manifestation s?Signs and Hyperthyroid symptoms ism

Nervousness Irritability The following are the Increased perspiration most common signs Thinning of the skin and symptoms of Fine, brittle hair hyperthyroidism . Weak muscles, especially in the However, each and upper arms individual may thighs experience Shaky hands manifestations Fast heartbeat differently.5/31/12 25

Hyperthyroidism

What are the manifestation s?Signs and Hyperthyroid symptoms ism

High blood pressure Increased bowel movements Weight loss Sleeping difficulty Prominent eyes Sensitivity to bright light Confusion Irregular menstrual cycle

The following are the most common signs and symptoms of hyperthyroidism . However, each individual may experience manifestations differently.26

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Medical management

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Medical management Hyperthyroidism

How the condition is treated depends on the cause and the severity of symptoms. Hyperthyroidism is usually treated with one or more of the following:

1.

Anti-thyroid medications Use of anti-thyroid drugs that help lower the level of thyroid hormones in the blood.

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Medical management Hyperthyroidism

Anti-thyroidHyperthyroidism 5/31/12 29

Medical management Hyperthyroidism

How the condition is treated depends on the cause and the severity of symptoms. Hyperthyroidism is usually treated with one or more of the following:

2.

Radioactive iodineexcess

Use of radioactive iodine, in the form of a pill or liquid, which damages thyroid cells so that production of thyroid hormones is slowed down

(which destroys thethyroidand stops the production of hormones)

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Medical management Hyperthyroidism

RadioactiveHyperthyroidism 5/31/12 31

Medical management Hyperthyroidism

How the condition is treated depends on the cause and the severity of symptoms. Hyperthyroidism is usually treated with one or more of the following:

3.

Surgery to remove part of the thyroid(the overactive nodule)

If thethyroidmust be removed with surgery or destroyed with rad