HIPERTHYROIDISM

CASE

A 27 years old women present to your office complaing of

progressing nervousness, fatigue,palpitations, and the recent
development of a resting hand tremor. She also states that she is
having difficulty concentrating at work and has been more
irrritable with her coworkers.the patient also notes that she has
developed a presistent rash over her shins that has not improved
with the use of topical steroid creams . All of her symptoms have
come on gradually over the past few months and continue to get
worse .review of systems also reveals an unintentional weight loss
of about 10 Ib,insomnia, nd amenorrhea for the past 2 month ( the
patients menstrual cycles are usually quite reguler ). The
patients past medical history is unremarkable and she takes no
oral medications .she is currently not sexually active and does not
drink alcohol ,smoke,or use any illicit drugs. On examination ,she
is afebrile . Her pulse varies from 70 to 110
beats/min.she
appears restless and anxious . Her skin is warm and moist . Her
eyes show evidence of exophthalmos and lid retraction bilaterally
, although funduscopic examination is normal . Neck examination
reveals symmetric thyroid enlargement , without any discrate
palpable masses . Carsiac examination reveals and irregular
rhythm. Her lungs are clear to auscultation .extremity

KEYWORD
A 27 years old women
Progressing nervousness, fatigue,palpitations, and
the recent development of a resting hand tremor
Difficulty concentrating at work and has been more
irrritable with her coworkers
Review of systems also reveals an unintentional
weight loss of about 10 Ib,insomnia, nd amenorrhea
for the past 2 month
Pulse varies from 70 to 110 beats/min
Exophthalmos and lid retraction bilaterally
Neck
examination
reveals
symmetric
thyroid
enlargement , without any discrate palpable masses

PROBLEM
A 27 years old women present
to your office complaing of
progressing nervousness,
fatigue,palpitations, and the
recent development of a resting
hand tremor.

HIPOTESA
A 27 years old women present to
your office complaing of progressing
nervousness, fatigue,palpitations,
and the recent development of a
resting hand tremor because
hyperthyroidism.

CONCLUSION
Hyperthyroidism is a term used to refer to simtoma
hyperactivity of the thyroid gland tissue that causes the
synthesis and secretion of thyroid hormone excess. At heart,
people with hyperthyroidism increased resting pulse rate, an
increase in left ventricular chamber contraction, which causes
a decrease in diastolic blood pressure and increase in systolic
pressure. Therefore, there is a decrease in serum cholesterol,
patients become more prone to heart rhythm disorders,
mainly due to fibrillation fibrillation. Advanced stages of
hyperthyroidism will cause thyrotoxicosis, and modulation
osteotrofik cytokines, such as IL-1, IL-6, IL-8 and TNF-. Some
causes of hyperthyroidism, among others, The iodine intake or
excessive thyroid hormone, low plasma selenium, Graves
disease, hyperplasia of the thyroid gland or pituitary, thyroid
inflammation, tumors of the testis or ovary. Some of the
complications caused by hyperthyroidism among others, AF

THANKS