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HIPERTIROID (TANDA DAN GEJALA (Symptoms ((Menstrual disturbances,…

- - - - Menstrual disturbances
      - Appetite/weight changes
      - Palpitations
      - Hyperactivity
      - Tremor
      - Heat intolerance
      - Increased perspiration
      - Weakness
      - Fatigue
      - Nervousness
  - - - Hyperactivity
      - Tachycardia
      - Systolic hypertension
      - Warm, moist, or smooth skin
      - Stare and eyelid retraction
      - Tremor
      - Hyperreflexia
      - Muscle weakness
- - - - Acute hyperthyroid symptoms
      - Goal of therapy:
        
        Inhibit synthesis and release of T4 and T3 from thyroid gland
        
        Inhibit peripheral conversion of T4 to T3
      - Propylthiouracil (PTU)
      - Methimazole
  - - - TSH:
        
        May rise transiently in recovery from other illness
        
        Pituitary hormone which stimulates thyroid
      - Free T4:
        
        transiently suppressed in severe acute illness
        
        direct measure of thyroxine activity
      - Free T3: suspect hyperthyroid but normal FT4
      - Thyroid peroxidase/thyroperoxidase antibody:
        
        Anti-TPO
        
        High levels in Hashimoto’s (95%) & Graves
        
        TSH receptor stimulating Ab measures activity in Graves-use in pregnancy
      - SCANS/ULTRASOUND
        
        Radioiodine uptake (RAIU)
        
        Thyroid Scan
        
        Ultrasound
        
        Fine needle Aspiration
- - - - fever 38-41°C
      - flushing
      - sweating
      - marked tachycardia ( ventricular tachyarrithmia )
      - atrial fibrilation
      - high pulse pressure
      - may complicated high output CHF
    - - Gastrointestinal symptom :
        
        nausea
        
        vomiting
        
        diarrhea
        
        jaundice
    - - CNS disturbances occur in 90% of patients :
        
        marked agitation
        
        restlessness
        
        delirium
        
        coma
    - - Fatal outcome is associated with :
        
        heart failure
        
        shock
        
        cardiac arrythmia