讲义案例教案35.pptxVIP

Hyperthyroidism  The First Affiliated hospital, Sun Yat-sen University Liu Liehua Class changing Time Original classes After exchange 5.21 Leukemia Hyper/Hypothyroidism 5.25 ITP Hyper/Hypothyroidism 6.4 Hyper/Hypothyroidism Leukemia 6.8 Hyper/Hypothyroidism ITP Schematic diagram of the thyroid cricoid cartilage Boundary: thyroid cartilage, 2nd/3rd tracheal ring Consist of Lateral lobes, isthmus, sometimes piramidal lobe Size of the lateral lobe：4-5cm×2-3cm×1-2cm Thyrotoxicosis and Hyperthyroidism :Definition Thyrotoxicosis: the state of thyroid hormone excess caused by any reason. Hyperthyroidism Thyrotoxicosis result from hyper function of the thyroid gland. The most frequent cause is Graves’ disease(GD), accounting for 80% of all cases of hyperthyroidism Overview of Graves’ disease (GD) Most common form of thyrotoxicosis It is an autoimmune disease characterized by clinical HT and presence of Abs directed against the TSH receptor May occur at any age but mostly from 20-40y more common in female than in male （4-6:1）. Syndrome consists of one or more of the following: Synptoms related to elevation of thyroid hormone(Thyroitoxicoxis) Goiter Opthalmopathy (exopthalmos) and Special manifestations (Dermopathy, myopathy) Inheretance: 15% had family histories Pathophysiology of Graves disease Circulation TSAb Clinical manifestation Most of the clinical manifestations result from activation of sympathetic nerve and increased metabolic rate. General manifestation nervousness, insomnia, fatigue, fine tremor, heat intolerance, weight loss Skin moistness, sweating, pretibial myxedema Eye Lid retraction exophthalmos, conjunctivitis, diplopia, 4. Cardiovascular System Palpitation, dyspnea, atrial fibrillation, congestive failure Clinical manifestation (2) 5. Digestive system hyperphagia, diarrhea, liver impairment 6. Reproductive system irregular menses, amenorrhea, decreased fertility 7. Neuromuscular system fine hand tremor,