甲亢英文课件

1、HyperthyroidismIntroductionDefinition：Function of thyroidism metabolism many systems excitability Most common is diffuse toxic goiter (Graves disease, GD) , 85%山东农业大学 计算机科学系Various causesGraves disease: 85%Autonomous toxic adenomas of the thyroid: Plummers disease or toxic multinodular goiter Jodbas

2、edow disease(Iodine-induced HT) Functioning thyroid carcinoma TSH hypersecretion by the pituitary Struma ovarii Subacute thyroiditis Hashimotos thyroiditis Thyrotoxicosis factitia Carcinoma accompanying thyrotoxicosis 山东农业大学 计算机科学系85%Male to female 1:4-6Chief clinical findingsGraves diseaseSymptoms

3、due to Hypermetabolism goitor Ophthalmopathy Abnormal immune: TRAb Heredity Infection: Molecular mimicry Cytokine Superantigen Spirit irritation Etiology and Pathophysiology山东农业大学 计算机科学系图1图2图3图4山东农业大学 计算机科学系Nervous system: Nervousness, emotional lability, irritability, fine tremor of hands.Cardiovas

4、cular: Palpitation, tachycardia, atrial fibrillation, widened pulse pressure.Gastrointestinal: Increased appetite, Hyperdefecation, diarrheaHematologic system: Moderate neutropenia, mild anemia. Others: Muscle atrophy, oligomenorrhear.Clinical manifestationCommon山东农业大学 计算机科学系Laboratory DiagnosisSeru

5、m T3, T4, FT3, FT4 Sensitive TSH assay Serum TRAbTest of TRH irritationRadioactive iodine uotake: Normal: 3h 5-25%, 24h 20-45%, peak at 24hThyroid scan: 131I, 99mTc山东农业大学 计算机科学系DiagnosisSymptomsSignsLaboratory examination山东农业大学 计算机科学系Differential diagnosisOther causes of thyrotoxicosisAnxiety neuros

6、is or maniaSome states of hypermetabolism without thyrotoxicosis: severe anemia, leukemia, etc.Cardiac disease: atrial fibrillation, anginaPheochromocytomaOther causes of ophthalmoplegia (myasthenia gravis) and exophthalmos (orbital tumor)Others: COPD, DM, cirrhosis of the liver.山东农业大学 计算机科学系Thionam

7、ides : TreatmentCommon use: a. Methimazole b. PropylthiouracilDosage and duration of thionamidesAdverse action: agranulocytosis, rash( including hives), Hepatitis(with PTU), Arthralgia, myalgia, neuritis, cholestasis(with MMI)Relapse山东农业大学 计算机科学系Iodinating agentsBeta-blocking agents: PropranololThyroid hormoneTreatmentOther medicine山东农业大学 计算机科学系Thyroid surgeryTreatmentIndication:Contraindication:山东农业大学 计算机科学系Trea