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H N i Ti t
Map 5.1 Cư ng giáp
Đi u Tr
•
B o t n: giáo d c cho b nh nhân, ngưng hút thu c lá.
•
Đi u tr b ng thu c:
Ki m soát tri u ch ng
Tr ng ng c và run: thu c ch n beta.
Tri u ch ng m t: thu c nh m t đ bôi trơn.
Thu c kháng giáp
Carbimazole
Propylthiouracil
Tác d ng ph : gi m b ch c u h t (theo dõi sát
công th c máu c a b nh nhân)
Đi u tr b ng iod phóng x
Đi u tr tri t đ ; B nh nhân ph i bình giáp trư c
khi đi u tr .
•
Ngo i khoa: C t bán ph n tuy n giáp; b nh nhân ph i bình giáp trư c khi
ph u thu t. Dùng Kali-iodua (KI) trư c khi ph u thu t đ gi m tư i máu t i
tuy n giáp.
Causes
Cause
Comment
Graves’ disease
•
This is the second most common cause of
hyperthyroidism
•
Risk increases with age
•
More common in females
•
A single nodule is suggestive of thyroid neoplasia
Toxic multinodular
goitre and toxic
solitary nodule goitre
•
This is the most common cause of hyperthyroidism
•
It is an autoimmune condition
•
May be distinguished from other causes of
hyperthyroidism by ocular changes, e.g. exophthalmos,
and other signs, e.g. pretibial myxoedema
•
It is associated with other autoimmune conditions
such as pernicious anaemia
De Quervain’s
thyroiditis
•
This is transient hyperthyroidism that develops after a
viral infection
•
Goitre is often painful
•
A period of hypothyroidism may follow
What is hyperthyroidism?
This occurs when there is too much circulating thyroid hormone in the body.
There are many different causes of hyperthyroidism.
C n lâm sàng
•
Xét nghi m tuy n giáp (
gi m
TSH, tăng T3 và T4).
•
Siêu âm tuy n giáp.
•
Ch c hút t bào n t đơn đ c
đ lo i tr t bào ác tính.
•
X hình tuy n giáp đ xem có
nhân nóng ho c nhân l nh.
Bi n Ch ng
•
Rung nhĩ.
•
Suy tim tăng cung lư ng.
•
B nh cơ tim.
•
Loãng xương.
MAP 5.1
Hyperthyroidism
Signs and symptoms
•
Weight loss.
•
Warm skin/heat intolerance.
•
Diarrhoea.
•
Exophthalmos (Graves’ disease).
•
Lid lag.
•
Palpitations.
•
Anxiety.
•
Tremor.
•
Goitre +/– bruit.
•
Brisk reflexes.
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