2. Definición Síndrome clínico resultado de la exposición a niveles elevados de hormona tiroidea Mayoritariamente por hiperfunción Ocasionalmente por otras causas
13. Etiología Manifestación de enfermedad autoinmune Predisposición familiar > 15% Familiares portadores de anticuerpos >50% Pico 20-40 a ñ os
14.
15.
16.
17.
18. Clasificación de Oftalmopatía (C) Daño corneal 5 (S) Vision disminuida (II par) 6 (E) Disfunción músculos extraoculares 4 (P) Proptosis 3 (S) Edema de tejido blando 2 (O) Solo signos - retracción parpado 1 (N)o Síntomas ni Signos 0 Caracteristica Clase
19.
20.
21.
22.
23.
24.
25.
26.
27.
28. Opciones de Tratamiento Cirugía Médico I131 1900’s Premio Nobel en Medicina a Kocker en 1909 1940’s Tionamidas introducidas por Atwood 1948 Introducido por Chapman (Hosp. Boston)
53. TRATAMIENTO Correccion del Hipertiroidismo Iodo T4 T3 Tiro-globulina PTU Metimazol T3 Yoduro Iopodato Litio PTU Iopodato B-Block Corticoides Plas- mafe- resis HD
54.
Editor's Notes
Clinicians should always looking for rapid pulse, when diagnosing Goiter is seen more with graves diseases than with the other hyperthyroid diseases -Warm, moist , or baby fine skin. -Tremor with outstretched hands When listening to the thyroid with a stethoscope you will hear a murmor over the throid gland thyroid bruit
Usually due to the stimulatory immunoglobulin that sits on the TSH receptor and stimulates the thyroid gland to make excessive thyroid hormone so your TSH will end up being low
The muscles of the eyes can also be trapped. You have so much thickening that it impinges on the optic nerve, as seen here in the CT scan.
This is what a thyroid scan looks like with graves disease Clinician is to examine at 6 hours and 24 hours and look at the % uptake of the radioactive iodine
There is only one nodule producing excessive amounts of thyroid hormone You can feel the nodule in the neck -Uptake scan have them take radioactive iodine and look at a picture of the neck, you will see one little hot spot in the thyroid gland itself.
This is an individual, who may be taking exogenous thyroid facticious thyroiditis
Lumpy throyroid gland, Graves tends to be more of a young middle adult disease, Multinodular is more with the elderly.
Sub Acute Thyroditis: If you palpate over the gland there will be pain. Sedimentation rate is an inflammatory marker that is used Silent thyroditis there is no pain, no inflammation marker. Post partum Thyroditis form of silent thyorditis, and occurs in women who deliver babies. They may complain of postpartum depression (which can start 16 weeks to 4 months after delivery) They have a high risk of developing thryoid disease later in life. Some may have autioimmune hyperthyroid disease Factitious Hyperthyrodism likely to be seen someone who is trying to loose weight. they have symptoms of hyerthroidsim without the goiter. In an uptake scan you won’t see any iodine uptake (why?) (the body doesn’t have to trap iodiine since TSH is being stimulated to inhibit the trapping of idoine, because the person is in taking exogenous hormone)
