I.

PATHOPHYSIOLOGY (BOOK BASED )

Predisposing Factors:
-female
-age: 30-50
-genetic defect
-HX of goiter

Precipitating Factor:
-Triggering event

Genetic malfunction causing

auto immune response

Recognition of TSI in
extra ocular muscles

Accumulation of fluids and fats

in the extra ocular muscles

Swelling behind the

eyeballs
Exophthalmos

Blurring of vision
Drug Therapy
Diuretics

Legend:
Production of thyroid stimulating
immunoglobulins(TSI)

TSI binds in thyrotrpin

receptors(TSH) receptors

Over stimulation of thyroid

gland
Diffuse enlarge ment of the
thyroid gland

Graves Disease

Radiation Therapy
Radioactive iodine
Surgical Therapy
Subtotal thyroidectomy
Increase production
of T3 hormone

Green Disease
Process
Violet Signs and
Symptoms
Blue - Factors
Black Complications
Management yellow
Red- -Disease

Drug Therapy
Antithyroid
drugs
methimazole (Tapazole)
propylthiouracil
(PTU)
-Adrenergic receptor
blockers
propranolol (Inderal)
atenolol

Increase in thyroid function

Hyperthyroidism

Decrease in TSH
THYROTOXICOSIS

Increase production
of T4 hormone

Increase in BMR

Increase production
of T3 hormone

Decrease in TSH

Hyperthyroidism

Increase production
of T4 hormone

Increase in Basal
Metabolic Rate

Over Stimulation of
metabolic rate

Increase the body's sensitivity

to Catecholamine

Cardiovascular System
Systolic
hypertension
Increased rate
and force of
cardiac
contractions
Bounding,
rapid
pulse
Increased cardiac
output
Cardiac
hypertrophy
Systolic
murmurs
Dysrhythmias
Palpitations
Atrial
fibrillatio
cardiac myopathy
Angina

Other
Intolerance to
heat
Elevated
basal
temperature
Lid lag,
stare
Eyelid
retraction
Goiter
(see
Fig. 50-6)
Rapid
speech

Integumentary System
Warm,
smooth,
moist
skin
Thin,brittle nails
detached from
nail bed
(onycholysis)
Hair loss
(may
be patchy)
Clubbing
of
fingers
(thyroid
acropachy) (see
Fig. 50-7)
Palmar
erythema
Fine silky
hair
Premature graying
(in men)
Diaphoresis
Vitiligo
Pretibial
myxedema

Musculoskeletal System
Fatigue
Muscle
weakness
Proximal
muscle
wasting
Dependent edema

Osteoporosis

Nervous System
Difficulty
focusing
eyes
Nervousness
Fine tremor (of
fingers
and
tongue)
Insomnia
Lability
of
mood,
delirium
Restlessness
Personality changes
of irritability,
agitation
Exhaustion
Hyperactive deeptendon reflexes
Depression, fatigue,
apathy
(in
the older adult)
Lack of
ability
to concentrate
Stupor,
coma

Respiratory System
Increased respiratory
rate
Dyspnea on mild
exertion

Gastrointestinal System
Increased
appetite,
thirst
Weight
loss
Increased
peristalsis
Diarrhea,
frequent
defecation
Increased bowel
sounds
Splenomegaly
Hepatomegaly

Reproductive System

Menstrual
irregularities

Amenorrhea

Decreased
libido

Impotence
in
men

Gynecomastia
in
men

Decreased
fertility