Hyperthyroidism Paper COMPLETE
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Transcript of Hyperthyroidism Paper COMPLETE
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CONTAIN
I. Abstract..2
Chapter 1 : Introduction
1.1. Case...3
1.2 Keyword...4
Chapter 2 : Frame of theory
2.1. Definition..5
2.2 Etiology.5
2.3 Sign and symptoms...6
2.4 Patopysiology!
2.5 "reatment..#
Chapter 3 : Analysis
3.1. "eory re$iew.12
3.2. Diagnosis.12
Chapter : !iscussion
4.1. %&estion.15
4.2. Dis'&ssion..15
Chapter " : Conclusion######################1$
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Abstract
(ypertyroidism is a 'ondition in wi' an o$era'ti$e tyroid gland is
prod&'ing an e)'essi$e amo&nt of tyroid ormones tat 'ir'&late in te *lood.
+,(yper, means ,o$er, in -ree/. "yroto)i'osis is a to)i' 'ondition tat is
'a&sed *y an e)'ess of tyroid ormones from any 'a&se.
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C%A&T'( 1
INT(O!)CTION
1.1. Case
0 2!year old woman presents to yo&r offi'e 'omplaining of progressing
ner$o&sness fatig&e palpitations and te re'ent de$elopment of resting and
tremor. Se also states tat se is a$ing diffi'<y 'on'etrating at wor and as*een more irita*le wit er 'oworers. "e patient also notes tat se as
de$eloped a persistent ras o$er er sins tat as not impro$ed wit te &se of
topi'al steroid 'reams. 0ll of er symptoms a$e 'ome on grad&ally o$er te past
few monts and 'ontin&e to get worse. e$iew of systems also re$eals an
&nintentional weigt loss of a*o&t 1 po&nds insomnia and ammenorea for te
past 2 monts +te patients menstr&al 'y'les are &s&ally &ite reg&lar/. "e
patients past medi'al istory &s &nremara*le and se taes no oral medi'ations.
Se is '&rrently not se)&ally a'ti$e and does not drin al'ool smoe or &se any
illi'it dr&gs. 7n e)amination e is afe*ril. (er p&lse $aries from !11 *eats per
min&te. Se appears restless and an)io&s er sin is warm and moist. (er eyes
sow e$iden'e of e)optalmos and lid retra'tion *ialterally alto&g f&nd&s'opi'
e)amination is normal. 8e' e)amination re$eals symmetri' tyroid enlargement
wito&t any dis'rete palpa*le masses. Cardia' e)amination re$eals an irreg&lar
rytm. (er l&ngs are 'lear to a&s'<ation. E)tremity e)amination re$eals an
erytemato&s ti'ened ras on *ot sins. 8e&rologi'al e)amination is normal
e)'ept for a fine resting tremor in er ands wen se attempts to old o&t er
o&tstret'ed arms. 9nitial la* tests in'l&de a negati$e pregnan'y test and
&ndete'ta*le le$el of tyroidstim&lating ormone +"S(/.
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1.2. *ey+ord
, 2! yearold woman, 8er$o&sness fatig&e and palpitations
, esting and tremor
, 9rita*le
, Persistent sins r&s +erytemato&s/
, :eigt loss of a*o&t 1 po&nds
, 9nsomnia
, 0mmenorrea
, Doesnt 'ons&me alool smoe or illi'it dr&gs.
, 0fe*rile
, estless and an)io&s
, 0ritmia, Symmetri' tyroid glands enlargement
, E)optalmos
, 8ot pregnant
, ;ndete'ta*le le$el of "S(
C%A&T'( 2
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F(A-' OF T%'O(
2.1. !efinition
(ypertyroidism is a 'ondition in wi' an o$era'ti$e tyroid gland is
prod&'ing an e)'essi$e amo&nt of tyroid ormones tat 'ir'&late in te *lood.
"yroto)i'osis is a to)i' 'ondition tat is 'a&sed *y an e)'ess of tyroid
ormones from any 'a&se. "yroto)i'osis 'an *e 'a&sed *y an e)'essi$e intae of
tyroid ormone or *y o$erprod&'tion of tyroid ormones *y te tyroid gland.
2.2. 'tiolo/y
Some 'ommon 'a&ses of ypertyroidism in'l&de&n'tioning adenoma +,ot nod&le,/ and to)i' m<inod&lar
goiter +"?8-/
E)'essi$e intae of tyroid ormones
0*normal se'retion of "S(
"yroiditis +inflammation of te tyroid gland/
E)'essi$e iodine intae
0raes !isease
-ra$es= disease wi' is 'a&sed *y a generali@ed o$era'ti$ity of te tyroid
gland is te most 'ommon 'a&se of ypertyroidism. 9n tis 'ondition te
tyroid gland &s&ally is renegade wi' means it as lost te a*ility to respond to
te normal 'ontrol *y te pit&itary gland $ia "S(. -ra$es= disease is ereditary
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and is &p to fi$e times more 'ommon among women tan men. -ra$es= disease is
to> to *e an a&toimm&ne disease and anti*odies tat are 'ara'teristi' of te
illness may *e fo&nd in te *lood. "ese anti*odies in'l&de tyroid stim&lating
imm&noglo*&lin +"S9 anti*odies/ tyroid pero)idase anti*odies +"P7/ and "S(
re'eptor anti*odies. "e triggers for -ra$e=s disease in'l&deatig&e
De'reased 'on'entration
9rreg&lar and s'ant menstr&al flow
9n older patients irreg&lar eart rytms and eart fail&re 'an o''&r. 9n its most
se$ere form &ntreated ypertyroidism may res< in ,tyroid storm, a 'ondition
in$ol$ing ig *lood press&re fe$er and eart fail&re. ?ental 'anges s&' as
'onf&sion and deliri&m also may o''&r.
2.. &athophysiolo/y
"yroid ormones stim&late te meta*olism of 'ells. "ey are prod&'ed *y
te tyroid gland. "e tyroid gland is lo'ated in te lower part of te ne' *elow
te 0dam=s apple. "e gland wraps aro&nd te windpipe +tra'ea/ and as a sapetat is similar to a *&tterfly formed *y two wings +lo*es/ and atta'ed *y a middle
part +istm&s/.
"e tyroid gland remo$es iodine from te *lood +wi' 'omes mostly from
a diet of foods s&' as seafood *read and salt/ and &ses it to prod&'e tyroid
ormones. "e two most important tyroid ormones are tyro)ine+"4/
"riiodotyronine +"3/ representing BB.B and .1 of tyroid ormones
respe'ti$ely. "e ormone wit te most *iologi'al a'ti$ity +for e)ample te
greatest effe't on te *ody/ is a't&ally "3. 7n'e released from te tyroid gland
into te *lood a large amo&nt of "4 is 'on$erted to "3 te more a'ti$e ormone
tat affe'ts te meta*olism of 'ells. "e tyroid itself is reg&lated *y anoter
gland lo'ated in te *rain 'alled te pit&itary.
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tyroid ormone tat is 'ir'&lating in te *lood +a ,feed*a', effe't of
tyroid ormone on te pit&itary gland/ and in part *y anoter gland 'alled te
ypotalam&s also a part of te *rain.
"e ypotalam&s releases a ormone 'alled tyrotropin releasing ormone
+"(/ wi' sends a signal to te pit&itary to release tyroid stim&lating
ormone +"S(/. 9n t&rn "S( sends a signal to te tyroid to release tyroid
ormones. 9f o$era'ti$ity of any of tese tree glands o''&rs an e)'essi$e amo&nt
of tyroid ormones 'an *e prod&'ed tere*y res<ing in ypertyroidism.
2.". Treatment
"e options for treating ypertyroidism in'l&deor
treating te symptoms we 'o&ld &se *eta *lo'ers for e)ample propanolol
atenolol and metoprolol. :e 'o&ld also &se antityroid dr&gs to *lo' te
prod&'tion of tyroid ormone. 0nd te last medi'ine is radioa'ti$e iodine +pill or
li&id/ to de'rease le$el of iodine.
C%A&T'( "
CONC4)ION
Gase on te 'ase we 'an mae a 'on'l&sion tis patient s&ffered from
ypertyroidism. :e a$e already nows a*o&t te patopysiology of
ypertyroidism tat 'an 'a&se some meta*olism tro&*le wi' sown *y tremor
fatig&e palpitations gland enlargement e)optalmos and oter symptoms. :it
te a''&rate anamnesis and some e)amination we 'an gi$e te *est terapy fortis patient to impro$e tis 'ondition.
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