 nervousness,fatigue , palpitations

 resting hand tremor

 difficulty concentrating at work
 has been more irritable with her coworkers
 persistent rash over her shins that has not improved with the use of
topical steroid creams
 weight loss of about 10 lb ,insomnia, and amenorrhea for the past 2
months
 on examination, she is afebrile. her pulse varies from 70 to 110
beats/min
 she appears restless and anxious
 her skin is warm and moist
 her eyes show evidence of exophthalmos and lid retraction bilaterally
 neck examination reveals symmetric thyroid enlargement, without any
discrete palpablemasses
 cardiac examination reveals an irregular rhythm
She has problem resting hand tremor , difficulty
concentrating at work and has been more
irritable with her coworkers
The hipotesa is hyperthyroidism
 DEFINISION
 Etiology
 Symptoms
 Risk factors
 Physical examination and investigation
 Treatment and education
 COMPLICATION
 Hyperthyroidism is a condition
caused by a clinic excessive
secretion of thyroid hormones are
thyroxine (T4) and triiodothyronine
(T3). Also found an increase in the
production of triiodothyronine (T3)
as a result of increasing the
conversion of thyroxine (T4) in the
peripheral tissues.
.
The disease is a form of hyperthyroidism
tiroktoksikosis most often encountered in
daily practice . Can occur at any age , often
found in women than men .
Hyperthyroid disease pathogenesis has so far
not known
The mechanism of autoimmunity is an
important factor in the pathogenesis of
hyperthyroidism
Patients complain of fatigue , trembling , can
not stand the heat , sweat more when hot ,
moist skin , weight loss despite increased
appetite , palpitations , tachycardia , diarrhea
and weakness and muscle atrophy .
•Occurs more in women than in men
•At the age of 50 years
•Post traumatic emotional
•Increased stress
 Physical examination in establishing the diagnosis of
hyperthyroidism is not only assess the thyroid gland
Physical examination may begin with examination on
the head and neck . examination begins with an
inspection of the thyroid gland in the neck front and
side with the patient sitting . Every scar , mass , and
distended veins that look to be recorded . After that ,
palpation of the gland tirod by asking the patient to flex
the muscles in the neck so that the neck rather slack
palpable thyroid gland of the patient and the presence
of the patient
 Investigation : Although the measurement of blood TSH
levels are best screening tool in assessing thyroid
function , but the severity of hyperthyroidism less can
be judged by the examination
 . 1. conservative : pharmacotherapy
a) Anti-thyroid: to inhibit the formation of
thyroid hormones.
Drugs Examples: Propiltiurazil (PTU),
methimazole (Tapazole)
Indications: In hyperthyroid disease.
 2. b. non-pharmacological : diet,not
comsume alcohol and ciggarettes
 3.Operative
 1. thyroid storm. Urgent situations
characterized high fever, rapid heart rate and
irregular (atrial fibrillation), unconscious until
death. This condition can occur as a result of
taking medications that are not disciplined.
 2. abnormality the eye in the form of dry
eyes, impaired vision, easy to infection,
wound up blind.
 3.Hipertensi, heart rhythm disorders to heart
failure.
 4.Osteoporosis
Hyperthyroidism is a condition caused by an
excessive secretion of clinical thyroid
hormones thyroxine (T4) and triiodothyronine
(T3).