Hyperthyroidism Pathphsiology

For medical education

1. By ; Dulsara Gunawardana - 301A’ (10.12.2020) Teacher : Elena Vasilevna Hyperthyroidism Path physiology of Hyperthyroidism

2. Definition Hyperthyroidism is abnormal condition of the body , which occurs when your thyroid gland produces too much of hormone thyroxine It can cause make toxicity in blood so called “Thyrotoxicosis”

3. Thyroid Hormones Chemical structure of Thyroid hormones are two hormones produced and released by thyroid gland namely Triiodothyronine (T3) Thyroxine (T4) They are tyrosine based hormones

4. Effects of thyroxine hormone It’s increase the metabolism Increase the activity of sympathetic nervous system So when highly increase synthesis of thyroxine hormone , it can lead Overactivity of sympathetic nervous system and highly increase of basal metabolism rate It is the development of “Hyperthyroidism “

5. Causes Myasthenia Gravis disease Toxic multi modular goiter Excessive intake of thyroid hormone Inflammation of thyroid gland Excessive intake of iodine

6. Hyperthyroidism effect to the Cardiovascular system Increase cardiac output Increase cotractility Occur tachycardia Palpitation of heart Cardiomegaly Arrhythmia s Particularly arterial fibrilization ( it’s rare case of older patients)

7. In cardiac myocytes , lymphocytic and eosinophilia infiltrations Fatty changes in myofibrils Increase the size and numbers of myocites In some peoples’ thyrotoxicosis develop reversibly , it can lead left ventricular dysfunction and heart failure ( It’s so called thyroid or hyperthyroid cardiomyopathy) Also in cvs increase peripheral oxrygen requirements

8. Hyperthyroidism effects to the Neuromuscular system Overactivity of sympathetic nervous system lead Tremor Hyperactive state Emotional lability Anxiety Inability to concentrate Insomnia

9. Hyperthyroidism effects to the Gastrointestinal system Hypermotility of the track Diarrhea Weight lose due to malabsorption Increase appetite

10. Hyperthyroidism effects to muscles Decrease the muscle mass ( thyroid myopathy) Atrophy of the skeletal muscles with fatty and focal interstitial lymphocytic infiltration Weakness of muscle

11. Hyperthyroidism effects to skeletal system Thyroid hormone stimulates bone resorption Increaseporosity of cortical bone and reducing the volume of trabecular bone Osteoporosis due to violations of calcium metabolism High risk with bone fractures

12. Hyperthyroidism effects to the skin Soft , warm ,fluished skin ( due to increase peripheral blood flow and vasodilation then heat lose) Increase sweating Increase humidity

13. Hyperthyroidism effects to ocular system A wide staring gaze and lid lag are present because of sympathetic overstimulation of the learterpalpebrae superioris . How ever , true thyroid ophthalmopathy associated with proposes is seen only in Gravis disease

14. Finally Minimal liver enlargement due to fatty acid changes in hepatocytes And Patient with Gravis Disease have generalizedlymphoid hyperplasia and lymphadenopathy N.B. : Gravis Disease (Myasthenia Gravis) is a long term neuromuscular disorder that leads to skeletal muscle disorders. The most commonly affected muscles are those of the eyes , face , and swallowing . It can lead double vision , drooping eyelids , trouble talking and trouble walking.

15. Diagnosis of Hyperthyroidism Thyroid function test TSH test (normal value : 0.5 - 1.5 mU/L) Thyroxine test ( normal value : 5 -12 mug/dL) Tri iodothyorine test And also we can do ECG

16. Clinical signs

17. Thank you 🙈