Hypothyroidism
Less active thyroid gland.
Types:
1 – Primary:
a – Hashimoto thyroditis: antibodies destroy the thyroid
tissue.
b – Over treatment of hyperthyroidism.
2 – Secondary: Disorder in Pituitary gland.
3 – Tertiary: Disorders in Hypothalamus.
Symptoms:
1 – Dry skin.
2 – Depression.
3 – Weight gain.
4 – Sensitivity to cold.
5 – Constipation.
6 – Change in menstruation( heavier).
7 – Muscle weakness.
8 – Joint pains.
9- Fatigue.
10 – Sleepness.
11 – Hair loss.
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12 – Finger weakness.
13 – General edema.
14 – Loss of sexual desire.
Signs:
1 – Thyroid enlargement.
2 – Hyporeactive reflex.
3- Bradycardia.
4 – Slow speech.
5 – Hypothermia( 36°C or less).
Investigations:
A – Laboratory:
1 – Low or normal T 3.
2 – Low or normal T4.
3 – High TSH.
B – Ultrasonic scan:
Shows diffuse enlargement of the thyroid gland.
Treatment:
Thyroxin hormone.
Case no.1:
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A woman 25 years complain from increased weight inspite she
does not eat and do dietary regime, fatigue, joint pains and she
feels cold inspit the weather is summer. When the doctor
examine, he found the temperature 36°C, blood pressure 120/80,
pulse 55/min.
A – What are the symptoms the doctor does not ask the
patient on it?
B – What are the signs does not shown by the doctor?
C -What are the investigations you need to diagnose the
case?
D - What is the diagnosis?
E - What is the plan for management?
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