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Essay About Hyperthyroidism, Essays (university) of Medicine

Hyperthyroidism, which is commonly known by the public, namely goiter is a thyroid problem that can cause swollen neck, hand tremors, and rashes on the skin or hives. More than 95% of hyperthyroidism is caused by morbus grave (toxic diffuse goiter) and morbus plummer (toxic diffuse goiter). Hyperthyroidism is a clinical condition caused by an increase in the concentration of thyroid hormone in tissues due to an increase in hormone synthesis by the thyroid gland in the form of an increase in the release of endogenous thyroid hormone or exogenous extrathyroidal sources. On the other hand, thyrotoxicosis refers to the clinical manifestations resulting from excessive turnover of thyroid hormone. The most common triggers of hyperthyroidism are Graves' disease, toxic multinodular goiter, and toxic adenoma. Another trigger that is also often found is thyroiditis, after which the rare causes include trophoblastic disease, excessive iodine consumption or thyroid hormone drugs, amiodarone drug

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2019/2020

Available from 08/31/2023

Anonym020812
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HYPERTHYROIDISM
1. Problem
In this endocrine and metabolic block essay, I will address the problem of an enlarged
neck, hand tremors, and accompanied by skin rashes or hives. Diseases that can cause
this problem are thyroid hormone levels that are too high or can also be called
hyperthyroidism.
2. Discussion
A. Hyperthyroidism
a. Definition
Hyperthyroidism, which is commonly known by the public, namely goiter is a
thyroid problem that can cause swollen neck, hand tremors, and rashes on the
skin or hives. More than 95% of hyperthyroidism is caused by morbus grave
(toxic diffuse goiter) and morbus plummer (toxic diffuse goiter).
Hyperthyroidism is a clinical condition caused by an increase in the
concentration of thyroid hormone in tissues due to an increase in hormone
synthesis by the thyroid gland in the form of an increase in the release of
endogenous thyroid hormone or exogenous extrathyroidal sources. On the
other hand, thyrotoxicosis refers to the clinical manifestations resulting from
excessive turnover of thyroid hormone. The most common triggers of
hyperthyroidism are Graves' disease, toxic multinodular goiter, and toxic
adenoma. Another trigger that is also often found is thyroiditis, after which the
rare causes include trophoblastic disease, excessive iodine consumption or
thyroid hormone drugs, amiodarone drugs and hypersecretion of Thyroid
Stimulating Hormone (TSH).
Raflesia Medical Daily Vol. 6 (1) 202031 the most common cause of
hyperthyroidism is found around 60-80% of all cases of thyrotoxicosis
worldwide. The prevalence of hyperthyroidism in Indonesia ranges from 6.9%
(Indonesian Basic Health Research Information, 2007) and in the United
States, the total prevalence of hyperthyroidism is 1.2%. and 0.8% in Europe.
Hyperthyroidism increases with age and is more common in women. The ratio
between women and men is 8:1 manifestation occurs in the third and fourth
decades of life. In some conditions, the signs and symptoms of
hyperthyroidism are very clear, and by physical examination alone,
thyrotoxicosis can be established quickly. In general, to diagnose the presence
of thyrotoxicosis and determine the cause requires an even, thorough,
thorough history and physical examination, assisted by supporting tests such
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HYPERTHYROIDISM

1. Problem In this endocrine and metabolic block essay, I will address the problem of an enlarged neck, hand tremors, and accompanied by skin rashes or hives. Diseases that can cause this problem are thyroid hormone levels that are too high or can also be called hyperthyroidism. 2. Discussion A. Hyperthyroidism a. Definition Hyperthyroidism, which is commonly known by the public, namely goiter is a thyroid problem that can cause swollen neck, hand tremors, and rashes on the skin or hives. More than 95% of hyperthyroidism is caused by morbus grave (toxic diffuse goiter) and morbus plummer (toxic diffuse goiter). Hyperthyroidism is a clinical condition caused by an increase in the concentration of thyroid hormone in tissues due to an increase in hormone synthesis by the thyroid gland in the form of an increase in the release of endogenous thyroid hormone or exogenous extrathyroidal sources. On the other hand, thyrotoxicosis refers to the clinical manifestations resulting from excessive turnover of thyroid hormone. The most common triggers of hyperthyroidism are Graves' disease, toxic multinodular goiter, and toxic adenoma. Another trigger that is also often found is thyroiditis, after which the rare causes include trophoblastic disease, excessive iodine consumption or thyroid hormone drugs, amiodarone drugs and hypersecretion of Thyroid Stimulating Hormone (TSH). Raflesia Medical Daily Vol. 6 (1) 202031 the most common cause of hyperthyroidism is found around 60-80% of all cases of thyrotoxicosis worldwide. The prevalence of hyperthyroidism in Indonesia ranges from 6.9% (Indonesian Basic Health Research Information, 2007) and in the United States, the total prevalence of hyperthyroidism is 1.2%. and 0.8% in Europe. Hyperthyroidism increases with age and is more common in women. The ratio between women and men is 8:1 manifestation occurs in the third and fourth decades of life. In some conditions, the signs and symptoms of hyperthyroidism are very clear, and by physical examination alone, thyrotoxicosis can be established quickly. In general, to diagnose the presence of thyrotoxicosis and determine the cause requires an even, thorough, thorough history and physical examination, assisted by supporting tests such

as laboratory checks for TSHs and FT4 levels, sometimes total T3. Hyperthyroid patients who are not treated can be at risk of reduced quality of life, and cause complications in the form of weight loss, fragility fractures, atrial fibrillation, embolism, cardiovascular dysfunction and osteoporosis. Therefore, treatment is needed to control thyroid hormone levels at reasonable limits, one of which is with antithyroid drugs. In the management of hyperthyroid disease, it is known that there are 3 treatment modalities, namely anti-thyroid drugs, thyroidectomy and radioablation, each with different advantages and symptoms and contraindications.

3. Risk factor a. Graves' disease is caused by autoimmunity or the body's own immunity that attacks normal cells. Graves' disease is a type of complaint in the body's immune system which is a common cause of hyperthyroidism, approaching 60-80% of all hyperthyroid problems in the world. Graves' disease associates thyroid-stimulating immunoglobulin (TSI) which binds to the thyroid-stimulating hormone receptor (TSHR) in the thyroid gland. Hyperthyroidism in Graves' disease is caused by autoantibodies against TSHR in the thyroid gland. When the TSHR is stimulated, thyroid hormone will be secreted in large quantities, which can then cause hyperthyroidism. b. Consuming drugs with high iodine content Iodine deficiency can also cause hyperthyroidism, through the mechanism of iodine- induced hyperthyroidism, partly due to iodine supplementation in endemic areas that is not properly monitored, access to iodine due to antithyroid drug treatment, access to drugs containing high iodine content such as amiodarone and expectorants. Consuming too much iodine, either from supplements or drugs, can stimulate the thyroid gland to produce excess thyroid hormone so that hyperthyroidism occurs. c. Presence of ovarian tumors and benign tumors of the thyroid or pituitary gland. Menstrual problems as a marker of ovarian function. Menstrual cycle disorders are caused by hormonal disorders related to thyroid problems, such as hyperthyroidism. 4. Symptoms or signs

  • Medical treatment
  1. Antithyroid drugs are given as the main treatment option in children with PG a. Methimazole (MMI): 0.2–0.5 milligram/kilogram day over a period of 1- years b. Titrate dose with guidelines for thyroid. c. Before giving anti-thyroid drugs, complete peripheral blood count, use the liver (bilirubin, transaminase and alkaline phosphatase). d. Stop the drug if the child has a fever, arthralgia, sores in the mouth, pharyngitis or malaise, and try measuring the leukocyte count. If you do not experience remissions within 2 years, evaluate adherence to treatment, drug side effects, and re-evaluate the treatment given. You may consider trying a thyroidectomy. a. If there is no MMI, then PTU can be given at an early dose of 5-7 mg/kg/day divided into 3 doses with close supervision, especially related to liver function. b. PTU must be discontinued if the transaminase level increases 2-3 times above the normal level and the level improves within 1 week after the test is repeated.
  • Symptomatic treatment
  • Beta adrenergic blockers (eg propranolol, atenolol, metoprolol) are recommended for children with hyperthyroidism whose heart rate is 100x/min.
  • Beta adrenergic blockers can be stopped when the thyroid hormone levels have reached reasonable limits.
  • Propanolol dose: 0. 5-2 milligrams/ kilogram/ day.
  • Surgical treatment
  • If surgery is chosen as the treatment for children with PG, then a near-total thyroidectomy is performed.
  • The operation must be performed by an experienced thyroid surgeon.
  • After surgery, children need replacement treatment or thyroid hormone replacement for life. Monitoring
  • Laboratory tests are attempted 4-6 weeks after initial treatment and each dose change. Repeat each 2-3 months when the dose is suitable.
  • TSH is often suppressed for quite a long time so dose adjustments are based on (fT4 or fT3).
  • After 2 years of antithyroid drug treatment and child still continuing treatment, laboratory monitoring is attempted every 6-12 months.
  • Long-term monitoring until old age is needed even though remission has occurred or has undergone surgery and radioactive iodine treatment.
  • Prognosis: 30% of children treated with antithyroid drugs achieve remission within 2 years. 75% of patients relapse within 6 months after stopping the drug, whereas only 10% relapse after 18 months. Thyroid crisis
  • Early treatment consists of: a. Look for triggers and treat causes. b. Rapidly lowering serum concentrations of thyroid hormone and exerting peripheral action on thyroid hormone.
  • The initial treatment option is PTU because it blocks T4 to T3 conversion.
  • PTU 100-200 milligrams each 4-6 hours orally or via NGT.
  • Iodides (SKKI) 8-10 drops every 8 hours to limit the release of hormones that have not yet been produced from the glands, must be given at least 1 hour after administration of PTU.
  • Propranolol 2mg/kg/day orally can block the adrenergic effect of thyroid hormone and limit the conversion of T4 to T3.