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Hyperthyroidism AEII.
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Hyperthyroidism AEII.
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Hyperthyroidism AEIIHyperthyroid Surgery - ANS-indications
Large goiter causing tracheal compression
Unresponsive to antithyroid therapy
Thyroid cancer
Not a candidate for RAI
More rapid reduction in T3 and T4 levels
Subtotal thyroidectomy
Preferred surgical procedure
Involves removal of 90% of thyroid
Can be done endoscopically
Total thyroidectomy (endoscopic & robotic)
Hyperthyroidism - ANS-A sustained ↑ in synthesis & release of thyroid hormones
More in women than men; ages 20 - 40 y/o
Graves Disease 75%- common form
Autoimmune disease of unknown etiology
Antibodies to TSH receptor stimulate release of T3, T4, or both
Leads to thyrotoxicosis
Remissions and exacerbations
May progress to destruction of thyroid tissue
Thyroid enlargement and excessive thyroid hormone secretions
↑ metabolism & sensitivity to sympathetic NS
Hyperthyroidism Assessment - ANS-History and physical
Clinical manifestations
CV (tachycardia, palpitation, HTN, dysrhythmia [atrial fib])
Goiter (enlarged thyroid)
Exophthalmia
Heat intolerance
Muscle weakness, fatigue
Mood/Emotional lability
Hyperthyroidism Diagnostic Studies - ANS-Lab findings: ↓ TSH & ↑ free thyroxine
(FreeT4) levels
ECG
Radioactive iodine uptake (RAIU)
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