Thyroid gland located in anterior neck between C5-T1

Formed

by to lobs connected by isthmus

TRH from hypothalamus to the pituitary to secret TSH
By

Thyroid glands secrete thyroid hormones (TH)

There’s important factors like iodine

Which is important for synthesis TH

hyperthyroidism

In

T4,T3 high

TSH low

Mainly

we measure the TSH to detect the abnormality

inactive

=

=T3-T4

Any process (abnormally -inflammation-

autoimmune disease to Thyroid gland ) that

cause increase in peripheral circulation of TH will

lead to thyrotoxicosis

triiodothyronine (T3)

thyroxine (T4)

Not very common as hypothyroidism

Broad nonspecific function but we can devide
more common

them into two major functions :

Comments 3 cause of hyperthyroidism:

Graves’ disease has 3 characteristics:

You don’t need to know the difference between 2 types of thyroiditis but in general it’s an
1.

Hyperthyroidism
inflammation in thyroid gland
Could be :
Autoimmune thyroiditis
2.

Opthalmopathy
Inflammation = TH released in body takes weeks to months = transit hyperthyroidism Secondary to infection
So thyroid can’t secret TH either back to normal or hypothyroidism Postpartum thyroiditis

Goitre
3.

Active

Multiple nodules producing TH

=There’s no activation of pituitary , from thyroid itself

Single (not multiple as TMG ) nodules

On advanced


hyperthyroidism


Could be in
Negative

feedback

On pituitary and hypothalamus

Graves’ disease

Secondary to

Depositions In retro orbital tissue

=protruding eye

Type of hyperthyroidism treatment

but worsen the ophthalmopathy

Of hyperthyroidism

Similar to symptoms of catecholamines

Any thyroid disorder

either hypo or hyper

By inspection

I Differences between systolic
and dystolic

Graves opththalmopathy

Preorbital

edema

up = lead retraction
Lead

: On the other hand , TMG - TUG

protruding
Don’t have antibodies

Lead
lag =asking patient to look down Redness =

the
lad lagging behind eyeball movement inflammation

Ultrasound

Fine needle inspiration

✓ For the thyroid nodules

To role out the cancer

✓ Same as TSH scan

Increasing in hyperthyroidism above the normal level

T4 = normally (9-19)


T3 = normally (2-4)

Normal -hyperthyroidism Hypothyroidism

We don’t request all labs together because they
=


costs lots of money


1- TSH

If

If abnormal = low = hyperthyroidism

TSH=low

2-T3-T4 FT4= normal

High = hyperthyroidism Then we will go to FT3

3- other tests lab We can found FT3 high,but FT4 is low

Mainly both will be fine FT3-4 espies in Graves’ disease
To detect which type of hyperthyroidism


If u suspect thyroid Multiple nodules or multi nodule glitter you will

use thyroid scan to see the uptake of thyroid

Hot nodules = hyperthyroidism

Cold nodules = need further investigation

Homogeneous

Normal uptake uptake

If the colour

less dominant
-

Hot nodules

than the

=High activity

normal = cold
High activity

nodules

050

Multi

Hot nodules nodules

Goitre
Hot nodules

=High activity =High activity

More than one spot of activity One area of thyroid uptake scan

very Low not normal

Normal

Can seen more with hypothyroidism

(more common)

Usually we don’t treat it

Treatment By:

Drugs

RAI (radioactive iodine )

Surgery

Depending on the patient states

Cause inflammation

End up with fibrosis

= hypothyroidism

Patient need thyroid replacement

+ Shortness of breath

Difficulty in swelling

Complications of hyperthyroidism can end up with :

High

and by labs

TSH = very suppress

T3-4 = very high