1 / 7

Presented By:Dr. M. Ramzan Rajput

HYPOTHYROIDISM. Presented By:Dr. M. Ramzan Rajput. MBBS, FCPS (Med). DEFINITION. Decrease secretion or function of thyroid gland or thyroxin. CLASSIFICATION. PRIMARY HYPOTHYROIDISM : Due to diseases of thyroid gland.

clint
Télécharger la présentation

Presented By:Dr. M. Ramzan Rajput

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. HYPOTHYROIDISM Presented By:Dr. M. Ramzan Rajput MBBS, FCPS (Med)

  2. DEFINITION • Decrease secretion or function of thyroid gland or thyroxin . CLASSIFICATION • PRIMARY HYPOTHYROIDISM: Due to diseases of thyroid gland. • Without Goitre : eg; Idiopathic /Autoimmune Atrophic Hypothyroidism, Radioactive Iodine Therapy, Thyroidectomy, Congenital Agenesis, Transient(Infection, Post partum thyroiditis, Thyroid hormone withdrawal). • With Goitre : eg; Hashimoto’s Thyroiditis, Drug Induced(INF, ATD, Amioderone, Lithium), Endemic Iodine Deficiency, Dyshormonogenesis/Inborn Errors, Infiltrative disorders ( Amyloidosis, Sarcoiudosis, Riedel’s thyroiditis. • 2. SECONDARY HYPOTHYROIDISM: Due to pituitary lesions. • 3. TERTIARY HYPOTHYROIDISM: Due to hypothalamic lesions.

  3. CLINICAL FEATURES: • COMMON: Weight gain, Cold intolerance, Fatigue, Somnolence, Dry skin & hair, Menorrhagia. • LESS COMMON: Constipation, Hoarseness, Carpal tunnel syndrome, Alopecia, Aches & pains, Muscle stiffness, Deafness, Depression, Infertility, Malar flush, Periorbital edema/Myxedema, Loss of lateral eyebrows, Anemia, Carotenemia, Bradycardia, Hypertension, Delayed relaxation of tendon reflexes, Dermal myxedema. • RARE: Psychosis ( Myxedema madness ), Galactorrhea, Impotence, Ileus, Ascites, Pericardial & Pleural Effusion, Cerebellar Ataxia, Myotonia.

  4. INVESTIGATIONS: T4 : Decreased. TSH : Increased ( > 20 Mu/L ). Thyroid peroidase antibodies, Antibodies to Thyroglobulin& TSH receptors : Increased. Serum CK, AST, LDH : Increased. Cholesterol : Increased. Na : Decreased. Anemia : NCNC / Macrocytic. ECG : Sinus bradycardia, Low voltage complexes, ST-Segment & T wave changes.

  5. MANAGEMENT: Thyroxin replacement therapy: • 1st 03 weeks = 50 micro grams/day. • Next 03 weeks = 100 micro grams/day. • maintenance = 100- 250 micrograms/day IN ISCHEMIC HEART DISEASE & ELDERLY PATIENTS: • Initial = 25-50 micro grams/day along with beta blockers and vasodilators. In non-responders to beta blockers and vasodilators PTCA or CABG may be required. HYPOTHYROID AND PREGNENCY: • Pregnant women require 50 micro grams more thyroxin than non- pregnant due to increase serum TBG.

  6. MYXEDEMA COMA: Severe Hypothyroidism In Elderly Patients. • Hypothermia. • Hypoglycemia. • Hyponatremia. • Confusion or Coma • TREATMENT IN MYXEDEMA COMA: • Inj: T3 20 micro grams I/V x 8 h for 48-72 h or Levo Thyroxin Na (400 micro grams I/V stat than 100 micro grams/day) followed by oral thyroxin 50 micro grams/day or through N/G tube. • Oxygen inhalation. • Hydrocortisone (100 mg I/V stat followed by 25-50 mg I/V 8 h). • 5% D/W. • Broad spectrum antibiotics. • Gradual re-warming by blankets. ENDS

More Related