ms L, 27 yo

Mutation in HLA-DR3
E:Autoimmune
-> Disturbance in
disorder
antigen recognizing

B lymphocytes produce
antibody against TSH

TSHR antibodies stimulate

TSHR in thyroid gland

Excessive production of T3 Negative feedback to

Radioiodine Therapy low TSH,TRH
and T4 in thyroid gland hypothalamus

PTU
Hyperthyroidsm
Anti-Thyroid

Thyroidectomy

D= Grave's disease

Propranolol Overstimulates Thyroid gland

Overstimulates sympathetic Beta-blockers Metabolism hyperplasia
nervous system

Goiter
Gluconeogenesis
Ocular Cardiac Muscular Thermogenesis O2 Need + Proteolysis + Lipolysis + glycolysis +

Tachycardia
RR+ Muscle weakness Hoarseness
Palpitation
Dysphagia

Fine tremor
Exopthalmous Weight loss
Hypereflexia
Excellent appetite

Blood Flow

Prognosis
Vascular Bruit

Ad Vitam: Ad bonam
Ad Functionam: Dubia Ad bonam