Andrew Maclennan, MD
Morning Report
5/18/2010
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Anxiety
Emotional lability
Weakness
Tremor
Palpitations
Heat intolerance
Increased perspiration
Weight loss despite a normal
or increased appetite
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Hyperactivity
Rapid speech
Lid retraction
Warm & moist skin
Thin hair
Tachycardia
Hypertension
Tremor
Prox muscle weakness
Hyperreflexia
Specific to Graves:
Proptosis
 Periorbital edema
 Pretibial myxedema
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TSH Mediated
•Pituitary adenoma
•( HCG disease)
Autonomous Production
•Graves’
•Hashimoto
•TMG
•Toxic adenoma
Subacute Thyroiditis
•Granulomatous
•Lymphocytic
Exogenous Intake
Ectopic Production
•Struma ovarii
•Metastatic follicular CA
Normal uptake
Increased uptake in
woman with Graves’
disease
Decreased uptake
in woman with
subacute
granulomatous
thyroiditis
•Radioactive iodine load
given
•Percent radioactive
iodine uptake measured
at:
•4 hr
•24 hrs  normal
uptake is between 1535%.
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Physiology, 2nd Edition. Costanzo
UpToDate
Tufts University Online Open Courseware –
Hyperthyroidism
http://ocw.tufts.edu/Content/14/lecturenotes/265881