Reliani
0107RIOOSS
Tutorial 1.I
1) patient's problems:
heat intolerance
-
increased perspiration
Skg weight loss
-
-
2) possible
causes
&
Heat intolerance:
-
->
sweating
explanations:
Anxiety
·
·Caffeine
↑ HR& metabolism
low
estrogen ->
->
->
heart
production
Menopause
impacts brain -> not flashes
->
·Thyrotoxicosis athermogenesis - heat intolerance
-
perspiration
-
·Menopause
Infection,leukemia, lymphoma
Malaria
-
Hyperthyroidism
-
weight
loss
Hyperthyroidism
->
↑
thermogenesis - heat intolerance
cancer
·
Diabetes
·
3)
sympathetic stimulation
-
Diabetic hypoglycemic
·
possible explanations for possible etiology
Thyrotoxicosis hyperthyroidism:
-
·
·
-
graves' disease
adeland
Thyrotoxicosis
Thyroiditis
wol
hyperparathyroidism:
siteatthefinebaracteria,
a
Fodine-induced hyperthyroidism
fungal
Dinmal
stress
Rhythm
↓
coldin infants
↓Hypothalamus I
-
↓
TRH
d
Anterior
-
I
pituitary -
Theroadglad
the
↓
↑ metabolic rate &heat
enhancement of growth
production;
development;
& cas
enhancement
of
sympathetic activity
Tutorial1.2
1) Explain findings?
-Cathetic -> muscle weakness
BP 130/80 mmHg (systolic prehypertensive)
-
resistance, increase
-
Temp
37.4°
BB
42kg
->
(slightly elevated) ->
↑
-Hand tremors,
2) Next
Ts dilates resistance arterioles, reducing systemic vascular
pulse pressure
10 &
-warm, moist extremities, hand tremors
-
->
↑ thermogenesis
->
activated sympathetic
thermogenesis
hyperhidrosis, palpitations, breathlessness
steps?
Strum TSH
-
Thyroid function test
-
CISH,Ts, T4]
-
Thyroid ultrasad
->
Get modul
Tutorial 2.1
1) Clinical patterns
-
-
LOW ISH
High thyroid hormones
-positive anti tPo
antibody
2) primary hyperthyroidism
3)treatment?
et causa
grave disease
on
exertion 3-4 months -> CNS overstimulation
-Drug therapy:B-blockers
for
rapid symptomatic sentin
thyroid-control
&
Hashimoto's
palpitations, anxiety.
Radioiodine (1311)
↳
-
Graves' disease
e.g:
↳Contraindications:
-
pregnant/breastfeeding
-children
women
(5y.0.
initial treatment
confirmed
-
-moderate severe Graves opthalmopathy
inability to follow radiation safety regulations.
the
Partial thyroidectomy:thyroid gland removed one of
↳ contraindications:
-
-
-
comorbidities
-severe
thyroid receptor
genes.
(cardiopulmo disease, end-stage cancer), pregnancy
Tutorial 2.2
i)
problems:
jarang/tidakrutin konsumsi
Thyroid storm symptoms
Burch-wartofsky
Score
2) possible
causes
Thyrotoxic
&
Crisis
->
explanations:
(thyroid
thyroid storm,
etiology of
a) Next
-
brykmuncul gegala
storm)
progresitivitas daripenyakitawalnya.
confirmdiagnosis, technetium
cek
Step:
·supportive
-
->
30, suggestive thyroid storm
3)Further info:
·
obat
isl, 53, 74
care
cairan->diare, muntal, muntah
air,
breathing,
circulation
-bpnaik:propanolol
40-00mg/6jam.
ANATOMY
Located in anterior neck,c5-51 vertebrae
a
2 lobes
left), connected by central isthmus anteriorly
(right
-
->
butterfly-shape
appearance
Anatomical
-
anteriorly
-laterally
-medially
relations:
->
->
infrahyoid muscle (Sternothyroid), superior belly omohyoid
carotid sheath, internal jugular vein, vagus nerve
organs (larynx, pharynx, trachea, esophagus),
recurrent laryngeall
->
nerves
a
sternohyoid
(external laryngeal,
vasculature:
-
Artery:superior thyroid artery
inferior---
Thyroid
-
venous
venous
ima
artery
plexus
around
thyroid gland
->
superior, middle, inferior
middle veins -> drain into jugular vein
Interior vein -> drain into branchiocephalic vein
superior
&
thyroid veins
Innervation
innervated by branches derived from sympathetic trunk
-Secretory function regulated by pituitary gland, not sympathetic trunkbranches
-
Lymphatic drainage:
·
-paratracheal
deep
&
cervical nodes
us
Hypothyroidisma
Hyper
Hypo
·SHOW HR
Low
body temp.
more hours of
sleep
·
sleep
·
apnea
constipation
↑
·
sensitivity
weightgain
·
I
or
·
·
freq.
bowel movements
sensitivity
·UTI/strong
cold right
to heat
urine stream
Isweating
sweats
·pain, stiffness/swelling in joints
menstrual periods
putty face
decrease libido
Hoarseness
blood cholesterol lvl
scalp stiffness & pain
Heavier
insomnia
more
to cold
Hemorrhoids
little/no sweat
·Fast HR
shortness of breath
less hours of sleep
weight loss
·
muscle weakness
period
eyes
thyroid popping out
·sudden paralysis
possible 4 in blood sugar In
light
menstrual
&
(perhaps diarrheal