医学ppt甲亢课件.ppt

Exopthalamos in Graves Disease Lid Lag in Graves Disease Prominent exophthalmos, activity limited, asymmetric Eyelids swelling, no closure, serious: eyeball fixation Photophobia, tears, diplopia, strabismus, eye distending pain,stabbing pain Impaired vision, constriction of visual field Corneal exposed、Ulcer or panophthalmitis —blindness invasive/malignant exophthalmos Clinical manifestation of special types 1, Hyperthyroidism crisis serious performance, with high fatality rate 2, Hyperthyroidism heart disease 3, Indifferent hyperthyroidism 4,T3 hyperthyroidism 5, Gestation hyperthyroidism 6、GRAVES ophthalmopathy with normal Thyroid function pretibial myxedema anterior lower tibia 1/3 symmetry skin coarsening thickening，clear boundary Red brown or dark purple bumps rough nodules Surrounding skin becomes thin, shiny， desquamation ,hair follicle keratinization anterior lower tibia 1/3 symmetry skin coarsening thickening clear boundary , bumps rough nodul hyperesthesia or hypoaesthesia , itchy sensation, late stage: orange dermoid, bark Yu Yu(Fanny) Hyperthyroidism 2012.10.29 Review contents: Thyroid anatomy (position, shape) Thyroid - human bodys largest endocrine gland organs with the most abundant blood supply The structure and function unit of the thyroid gland - thyroid follicle the height of follicle epithelial cells is in direct proportion with thyroid function, the size of follicular cavity is inversely proportional with the thyroid function . Thyroid hormone secretion Thyroid anatomy (position, shape) anterior pituitary paraventricular nucleus Hypothalamus Anterior Pituitary Thyroid gland TRH + + TSH Thyroid - T4, T3 - SRIF 5-deiodination (outer ring) T T3 active 5-deiodination (inner ring) T rT3 inactive Thyroid hormone metabolism Regulatory mechanisms Etiological classification Six big types Thyroid hyperthyroidism Pituitary hyperthyroidism hyperthyroidism Tumor accompanied syndrome