Graves' disease by Micheala Richardson https://padlet.com/mrich6185/vt9b5576j6bejgup en-us 2022-10-03 20:59:32 UTC 2025-12-14 13:51:47 UTC hello@padlet.com Risk Factors: mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2324571505 2022-10-03 21:04:42 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2324571505 Tissue/Organ Pathophysiology: mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2324573704 2022-10-03 21:06:53 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2324573704 Type II Hypersensitivity tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325711595 - non-cytotoxic
- tissue specific reaction
- infiltration of lymphocytes
- stimulation of antibodies (IgG, IgM) directed against TSH receptor on thyroid cells (McCance, 2019)]]> 2022-10-04 13:39:42 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325711595 Does this condition conform to the traditional definition? tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325714172 2022-10-04 13:40:56 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325714172 Clinical Manifestations tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325715417 2022-10-04 13:41:31 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325715417 Expected Therapeutic Management tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325715962 2022-10-04 13:41:47 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325715962 Medication tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325728418 Antithyroid drugs: interfere with the thyroid's ability to use iodine to produce hormones (Pruthi, 2022) 
- methimazole
- propylthiouracil (McCance, 2019)

Other drugs:
- beta blockers to treat cardiac symptoms (Pruthi, 2022)]]> 2022-10-04 13:47:18 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325728418 Radioactive iodine ablation tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325729690 - absorbed only by thyroid tissue
- causes cell death -> hypothyroidism (McCance, 2019)
- lifelong hormone replacement therapy (levothyroxine) (Pruhti, 2022)]]> 2022-10-04 13:47:53 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325729690 Surgery tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325730341 - complete or partial removal of the thyroid (thyroidectomy) 
- lifelong hormone replacement therapy (levothyroxine)
(Pruthi, 2022)]]> 2022-10-04 13:48:11 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325730341 Progressive ophthalmology: tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325748042 - Surgical orbital decompression and glucocorticoids (McCance, 2019)
- radioactive iodine treatment may not help or may make symptoms worse ("Thyroid eye disease", 2021)]]> 2022-10-04 13:56:18 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325748042 Genetic Factors: mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325752740 -Family History
-Sex: It is more common for women to have Graves' disease than men.
-Other autoimmune disorders: Examples are Type 1 diabetes and Rheumatoid Arthritis 
(Pruthi, 2022) ]]> 2022-10-04 13:58:21 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325752740 Autoimmune disease tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325755527 2022-10-04 13:59:34 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325755527 Overview sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325763233 2022-10-04 14:03:09 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325763233 Ophthalmopathy tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325763619 - bulging eyes
- red, dry eyes
- protracted eyelid
- pressure or pain
- double vision
- results from inflammation around eye (McCance, 2019)
- half of patients with Graves disease have symptoms of ophthalmopathy
(Bahn, 2010)]]> 2022-10-04 14:03:21 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325763619 tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325765764 2022-10-04 14:04:25 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325765764 Thyroid gland sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325768156 It's an endocrine gland that produces thyroid hormones triiodothyronine (T3) and thyroxine (T4), which maintain homeostasis in the body, and ensure proper organ function and body metabolism (McCance & Heuther, 2019).]]> 2022-10-04 14:05:32 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325768156 Dermopathy tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325772707 - rare skin condition
- red, swollen shins (McCance, 2019)
- nodular or diffuse thickening of pretibial skin (Bahn, 2010)
(Image: Bartalena, 2018)]]> 2022-10-04 14:07:27 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325772707 Hyperthyroidism sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325789297 A form of thyrotoxicity, hyperthyroidism involves excess thyroid stimulating hormone (TSH) secretion from the thyroid gland. It controls the amount of thyroid hormone released. Graves disease is a cause of 50-80% of hyperthyroidism cases, mostly in women (McCance & Heuther, 2019).]]> 2022-10-04 14:14:31 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325789297 Cell pathophysiology sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325794233 2022-10-04 14:16:51 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325794233 Thyroid stimulation sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325798890 Antigens in the thyroid gland stimulate T lymphocytes. They in turn stimulate
B lymphocytes to synthesize thyroid stimulating immunoglobulin (TSI) in thyroid cells, bone marrow, or lymph nodes. TSI binds to and continuously activates thyrotropic receptors, which can lead to overproduction of TSH. ]]> 2022-10-04 14:18:26 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325798890 sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325800162 Hyperplasia = goiter (enlarged thyroid)]]> 2022-10-04 14:19:02 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325800162 Hyperthyroidism tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325806314 - enlarged thyroid gland (goiter) ("Goiter", 2022; McCance, 2019)

symptoms of hypermetabolism:
- menstrual cycle alterations
- GI: weight loss, increased peristalsis, nausea, vomiting, anorexia, abdominal pain
- increased sweating, flushing, warm skin, heat intolerance
- increased cardiac output and decreased peripheral resistance, tachycardia at rest, loud heart sounds, supraventricular dysrhythmias, left ventricular dilation and hypertrophy
- restlessness, compulsive movement, short attention span, fatigue, tremor, insomnia, increased appetite, emotional lability
- dyspnea, reduced vital capacity
(McCance, 2019)]]> 2022-10-04 14:21:37 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325806314 Activation sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325808617 Thyroid follicles increase production of mostly triiodothyronine (T3) and some thyroxine (T4) - thyroid hormones]]> 2022-10-04 14:22:38 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325808617 Genetic and Environmental Factors sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325833228 It's an autoimmune disease from type II hypersensitivity that is exacerbated by stress, smoking, and exposure to iodine. Family history of the condition can predispose individuals to developing it.]]> 2022-10-04 14:33:55 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325833228 References tstef3658 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325893885 Bahn R. S. (2010). Graves' ophthalmopathy. The New England journal of medicine, 362(8), 726–738. https://doi.org/10.1056/NEJMra0905750

Bartalena, L. (2018, February). Graves’ disease: Complications. Endotext. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK285551/

Desai, R., Marshall, T., Debevec-McKenney, E., Ryan, J., Solar, E., & Norton, B. (2022). Osmosis: Graves disease. Elsevier. Retrieved from https://www.osmosis.org/learn/Graves_disease.

Elia, G., Fallahi, P., Ragusa, F., Paparo, S. R., Mazzi, V., Benvenga, S., Antonelli, A., & Ferrari, S. M. (2021). Precision Medicine in Graves' Disease and Ophthalmopathy. Frontiers in pharmacology, 12, 754386. https://doi.org/10.3389/fphar.2021.754386

Goiter. Baylor College of Medicine. (2022). Retrieved from https://www.bcm.edu/healthcare/specialties/endocrinology/endocrine-surgery/goiter

Holthoff, H. P., Uhland, K., Kovacs, G. L., Reimann, A., Adler, K., Wenhart, C., & Ungerer, M. (2020). Thyroid-stimulating hormone receptor (TSHR) fusion proteins in Graves' disease. The Journal of endocrinology, 246(2), 135–147. https://doi.org/10.1530/JOE-20-0061

McCance, K. L., & Heuther, S. (2019). Pathophysiology (8th ed.). Elsevier.

Pruthi, S. (Ed.). (2022, June 14). Graves' disease. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/graves-disease/diagnosis-treatment/drc-20356245

Pokhrel, B., Bhusal, K. (2022, June 22). Graves Disease. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK448195/

Thyroid eye disease. British Thyroid Foundation. (2021). Retrieved from https://www.btf-thyroid.org/thyroid-eye-disease-leaflet#:~:text=What%20is%20Thyroid%20Eye%20Disease,or%20'bulging'%20eyes). ]]> 2022-10-04 15:03:27 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2325893885 mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326257633 2022-10-04 18:13:36 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326257633 Environmental: mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326308670 -Stress
-Smoking
-Pregnancy (mostly post-partum)
-Infection
These environmental factors can trigger immune responses on specific genes that lead to Graves Disease (Pruthi, 2022) 

]]> 2022-10-04 18:43:40 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326308670 Target organ: Thyroid Gland mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326592764 - Hypothalamus releases thyroid releasing hormone (TRH) -->
- Pituitary gland releases thyroid stimulating hormone (TSH) --> 
TSH travels via circulation to the thyroid gland and binds to TSH binding receptors
(Pokhrel & Bhusal, 2022)]]> 2022-10-04 23:29:40 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326592764 mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326595321 - Stimulates thyroid gland to produce thyroid hormones (T3 and T4)
- Negative feedback loop will stop the hypothalamus and pituitary gland from releasing more TRH and TSH 
(Pokhrel & Bhusal, 2022)

]]> 2022-10-04 23:32:57 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326595321 Auto-antibodies mimic TSH mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326602495 -Auto-antibodies (antibodies against self) are being produced in Graves Disease. These mimic TSH and bind to TSH receptors.
- This continues to increase levels of T3 and T4 even after the negative feedback loop.
- Overactivity of thyroid hormones and thyroid gland growth
(Pokhrel & Bhusal, 2022)]]> 2022-10-04 23:41:38 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326602495 Ophthalmopathy causes: mrich6185 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326631779 Thyroid stimulating antibodies and cytokines activate: 
-periorbital fibroblasts
-preadipocytes
Leads to: synthesis of excess glycosaminoglycans (GAG) which trap water and cause muscle swelling. 
This can also lead to: buldging eyes, double vision, congestion, and periorbital edema (Pokhrel & Bhusal, 2022).  
]]> 2022-10-05 00:13:17 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326631779 Typical Symptoms and Treatment: sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326970736 Symptoms usually include goiter, bulging eyes, red or swollen shins, nausea, vomiting, weight loss, sweating, fatigue and restlessness. Treatments can range from antithyroid drugs to radioactive iodine administration, as well as surgery. (McCance & Heuther, 2019).]]> 2022-10-05 05:16:16 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2326970736 Opthalmopathy Etiology sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2327007299 Cytotoxic T lymphocytes, also known as killer T cells, release cytokines that work with TSI to cause inflammation and growth of extraocular muscles and surrounding connective tissue. This is done by activating preadipocytes and periorbital fibroblasts, which synthesize glycosaminoglycans and fat growth in the retro-orbital area (Elia et al., 2021).]]> 2022-10-05 05:54:18 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2327007299 sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2327008825 Swelling of muscle, edema, congestion, and eventual ophthalmopathy. ]]> 2022-10-05 05:55:58 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2327008825 GD Contributing Factors sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2328282630 - T and B lymphocyte cells proliferate with not enough regulatory T cells to suppress their overproduction. 
-Human leukocyte antigen (HLA-D) has a high affinity for the TSHR gene, which is the receptor for TSH (Holthoff et al., 2020).]]> 2022-10-05 20:53:24 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2328282630 sonalirajput775 https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2328284837 More TSHR = more places for TSH to bind = increased T3 and T4 production (Holthoff et al., 2020).]]> 2022-10-05 20:56:02 UTC https://padlet.com/mrich6185/vt9b5576j6bejgup/wish/2328284837