Abnormalities of thyroid function
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ABNORMALITIES OF THYROID FUNCTION. ENDO BLOCK 412. Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College. Objectives. The student should be able to: Describe the etiology, symptoms and treatment of thyrotoxicosis and hypothyroidism. Abnormalities. Hypothyroidism

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ABNORMALITIES OF THYROID FUNCTION

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Abnormalities of thyroid function

ABNORMALITIES OF THYROID FUNCTION

ENDO BLOCK 412

Dr. ShaikhMujeeb Ahmed

Assistant Professor

AlMaarefa College


Objectives

Objectives

  • The student should be able to:

  • Describe the etiology, symptoms and treatment of thyrotoxicosis and hypothyroidism.


Abnormalities

Abnormalities

  • Hypothyroidism

    • Deficient thyroid hormone secretion

  • Hyperthyroidism

    • Excess thyroid hormone secretion


Hypothyroidism

Hypothyroidism

  • Primary failure of thyroid gland itself

  • Secondary to deficiency of TRH, TSH or both.

  • From an inadequate dietary supply of iodine.


Clinical features

Clinical features

  • The symptoms of hypothyroidism are largely caused by a reduction in overall metabolic activity.

  • Reduced BMR (less energy expenditure at rest);

  • Displays poor tolerance of cold (lack of the calorigenic effect);

  • Tendency to gain excessive weight (not burning fuels at a normal rate);

  • Easily fatigued (lower energy production);

  • Slow, weak pulse (caused by a reduction in the rate and strength of cardiac contraction and a lowered cardiac output); and

  • Exhibits slow reflexes and slow mental responsiveness (because of the effect on the nervous system). The

  • Mental effects are characterized by diminished alertness, slow speech, and poor memory.


Causes of congenital hypothyroidism

Causes of congenital hypothyroidism

  • Maternal iodine deficiency

  • Fetal thyroid dysgenesis

  • Inborn errors of thyroid hormone synthesis

  • Maternal antithyroid antibodies that cross the placenta

  • Fetal hypopituitary hypothyroidism


Myxedema adult hypothyroidism

MYXEDEMA (Adult Hypothyroidism)

Puffy appearance, primarily of face, hands, and feet

Caused by infiltration of skin with complex water retaining carbohydrate molecules.

Symptoms: The patient becomes sluggish both mentally and physically and often feels cold. The hair becomes dry and the skin becomes dry and waxy. The tissues of the face swell.

Treatment:

– If diagnosed early, can be treated by administrating of T4.

– Exception, if hypothyroidism caused by iodine deficiency; treated by dietary iodine.


Cretinism

Cretinism

  • Results from hypothyroidism from birth

  • Characterized by dwarfism & mental retardation as well as other general symptoms of thyroid deficiency.

  • At birth, child appears normal because thyroxine is received from mother through placenta

  • Symptoms: growth retardation, abnormal bone development, low body temperature, lethargy, severely mentally retarded (short limbs, a large protruding tongue, coarse dry skin, poor abdominal muscle, tone and an umbilical hernia).


Cretinism1

Cretinism


Hyperthyroidism

HYPERTHYROIDISM

  • The most common cause of hyperthyroidism is Graves’ disease.

  • immune disease

  • thyroid-stimulating immunoglobulin (TSI), also known as long-acting thyroid stimulator (LATS),

  • ↑ BMR

  • poor tolerance of heat

  • Increased appetite

  • body weight

  • muscle weakness

  • Muscle termers

  • Sleep

  • ↑ Heart rate

  • ↑COP

  • Irritable, tense, anxious

  • Exophthalmos (bulging eyes) (grave’s disease)


Abnormalities of thyroid function

Fig. 19-4, p. 696


Abnormalities of thyroid function

Fig. 19-5, p. 697


Abnormalities of thyroid function

  • Anti thyroid drugs

  • Surgical removal

  • Administration of radioactive iodine


Goiter

GOITER

  • A goiter is an enlarged thyroid gland.

  • Occurs when either TSH or TSI excessively stimulates the thyroid gland.

  • The most common cause of goiter worldwide is a lack of iodine in the diet.


Causes of goiter

Causes of Goiter

  • Iodine deficiency

  • Graves' disease

  • Hashimoto's disease

  • Multinodulargoiter

  • Solitary thyroid nodules

  • Thyroid cancer

  • Pregnancy

  • Inflammation

Fig. 19-6, p. 697


Abnormalities of thyroid function

Table 19-1, p. 696


Synthesis storage and secretion of thyroid hormone

Synthesis, storage, and secretion of thyroid hormone

Thiouracil

Thiocynate

X

X


Antithyroid substances

Antithyroid Substances

  • Thiocyanate Ions

    • Decrease Iodide Trapping

    • inhibition of the iodide-trapping mechanism

  • Propylthiouracil

    • Decreases Thyroid Hormone Formation Propylthiouracil & similar compounds as

    • methimazole and carbimazole

    • block the peroxidase enzyme

  • Iodides in high concentrations decrease thyroid activity and thyroid gland size


References

References

  • Human physiology, Lauralee Sherwood, seventh edition.

  • Text book physiology by Guyton &Hall,11th edition.

  • Text book of physiology by Linda .S .Costanzo third edition


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