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ROUTINE STUDIES TAROT Tet ee Tormal Commer Biecbd LATS snes wal MetArt me 12186 boy raise Sieve A528 Cog OBE-271 paola se em, meal Tae OH 300 age ee lowe ase Belem 048-238 tape. Sees UALS ep oon-te isp USSD sign” oss oa 20 ex TN 4 e283 Belem a2 Hees 8.250 eae” ais aay nat TwHietimy 0-36 S185 Te gee sae tam 0-8 lum S30¢ —aags—itemnmnem 30m te SLeitme 082-805 Sh asa wae mt rosy 05-055 allem ng. Clea es Eady OBE-k1e sagen anna ii, Sle 045-850 gras pnt vals whe Sete ier 73 ear taps, fel 2 Manisa, tele 1836 ib 7-35 fel EL Matt feel 15-28 a 25 fel 128 sy Mak fel 1228 ‘ig facane an eatin abe BE anaee a pag Teas Dagens uta a WE Hage rane ats a ey 250 _ Part Diagnostic and Therapeutic Information SERUM TN PRETEI AND TERM ANTS es ta 7 Tae 1 7s niae2s “ es228 ses05 m0 Ga aseus ho spin sen 28 toss, sian 238 Tats men Thee asi te, 2, Graves disease 2, Physical exam: Dillse goer, 2 ealing ol gitiness ene discern the eye, rettooulbar pressure or pain eelc lag or reaction, peirtitel ‘edema, cnemosls, scleral injection, xopithalmr, extoocusr muscle 4ystunction, loelzed dermapathy, and mahoid typeroless Epidemiology: Peak incidence: age 11-15 yeas. 5:1 femalede-male ratio, Family history of sutoimmune thyroid disease ¢. Blclogy: Autormmune (sive TSI, may also have fw Utes of thyraglbuln # microsomal aniaadis) 4. Lab findings: TT, 7Ts, ETSH (71 uptake distinguishes trom Feshimoto's thyridis) ‘2. Treatment and menitring: Methimazole {inhibits formation of tyre hormane!, Propylhiouacl(PTU) should nat be uses 6s frs-line lrealment in chiren due lo higher sk of Iver dysfunction than with meth maze; PTU can be considered for thse with mild reactions to methimazcle. Radlactve leine lor surgical hyradec‘omy are ‘options for nil reste or rectory cases, Follow sympioms and Tova fT. and TSH 3 Hashimotesthyroiis 2, Presonalion: + nial hyparthyroieism flowed by eventual bur out of the thyroid ane hyoahyroidism Eliclogy: Auimmune ‘significant elevated thyoglebuln andor Imictsemal ans) ¢. Lab findings: Mil to moderate TT, (LI uptake distinguishes trom Graves 4. Treatment: Hypartnyeoié phase is usual selmited, may eventually ees thyoid replacement Propranlel i symptomatic 4, Thyroid storm 6 Presentation: Acute onset of hypertermis,tachyeatda, ard reslassness. May progress te delirium, coma, and death , Trestment:Propranololis used orelleve signs ana symptoms of Uryroloxicosis,Polassium fide may also be used for acu hyperthyroid management. Longcem management s ‘or Graves disease