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Chapter 7 Endocrine System Section 4 Triple Hypothyroidism
This is a mind map about Chapter 7, Endocrine System, Section 4, Triple Hypothyroidism, with a detailed introduction and comprehensive description. I hope it will be helpful to those who are interested!
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Chapter 7 Endocrine System Section 4 Triple Hypothyroidism
- bacteria
This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
- Plant asexual reproduction
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3. Hypothyroidism
hypothyroidism
Hypothyroidism, for short, refers to systemic hypometabolic syndrome caused by hypothyroidism or thyroid hormone resistance due to various reasons, which manifests as myxedema.
Hypothyroidism originating in the fetus or newborn - cretinism, also known as cretinism, is often accompanied by intellectual disability and developmental delay.
Cause and pathogenesis
Autoimmune damage is the most common cause
Thyroid destruction: surgery, iodine 131 treatment.
clinical manifestations
hypometabolic syndrome
Easily tired, afraid of cold, body temperature may be lower than normal
Psycho-nervous system: prominent symptoms of drowsiness and slow reaction. Severe cases include dementia, hallucinations, lethargy, and convulsions.
Skin changes: Myxedematous appearance. Myxedema of the skin (non-pitting) is common around the eyes, on the dorsum of the hands and feet, and in the supraclavicular fossa. The voice is low and hoarse, the expression is dull, and the skin is dry, flaky and cold. The outer 1/3 of the eyebrows fell off. The skin of the hands and feet is ginger-yellow.
Muscles and joints: progressive muscle weakness and atrophy.
Cardiovascular system: Myxedema leads to heart enlargement, hypothyroid heart disease, and those who have been ill for a long time are prone to coronary heart disease.
Blood system: anemia.
Aerobic reduction of insufficient EPO production - positive pigments
Malabsorption, insufficient intake, insufficient folic acid b12 - large cells
Heavy menstrual flow, achlorhydria--insufficient iron absorption--small cells
Digestive system: fear of food, bloating, constipation, severe paralytic ileus or myxedema megacolon
Endocrine reproductive system: long-term can lead to hyperprolactinemia and galactorrhea. Growth retardation in children. Severe hypothyroidism in women leads to increased menstrual bleeding and ovulation disorders.
Myxedema coma: onset when cold. The trigger is stress. Lethargy and hypothermia are life-threatening due to heart and kidney failure.
laboratory tests
Decreased high-density lipoprotein, normocytic normochromic anemia
Reduced TT4 and FT4 are necessary indicators for diagnosis. Serum TSH is the most sensitive and early first-line indicator for evaluating primary thyroid dysfunction. TT3 and FT3 are normal in the early stage and decreased in the late stage.
The TRH stimulation test is used to differentiate between pituitary hypothyroidism and hypothalamic hypothyroidism. If it is not increased, it is pituitary; if it is delayed, it is hypothalamic.
Treatment points
alternative treatment
Goal: Correct hypothyroidism with minimal dose without significant adverse effects.
Oral levothyroxine is the first choice, lifelong replacement therapy
Symptomatic treatment: supplement whatever is needed. Low gastric acid supplement dilute hydrochloric acid - combined with L-T4
Treatment of subclinical hypothyroidism: L-T4 treatment - as long as there is hypercholesterolemia and serum thyroid-stimulating hormone is greater than 10mU per liter.
Treatment of Myxedema Coma
Intravenous injection of L-T3 is preferred, and oral administration is recommended after recovery.
Keep warm, breathe oxygen, and keep your respiratory tract clear
Continuous intravenous infusion of hydrocortisone
Rehydration as needed
Control infection and treat primary disease
Nursing diagnosis
constipate
Diet care
Low in sodium and fat, eating crude fiber foods promotes peristalsis. Hashimoto avoids iodine-containing foods and medicines to avoid inducing severe myxedema.
Defecate regularly and regularly. Promote bowel movements (massage, exercise, etc.)
Medication care L-T4, take 30-60 minutes before breakfast
hypothermia
Enhance warmth
Room temperature 22-23
Condition observation
Potential complications: Myxedema coma
Overweight/Obesity: Intake greater than needs and low metabolic rate
Inability to move
sexual dysfunction
health guidance
Medication guidance
Symptoms of excess thyroid hormone
Losing weight after eating too much, pulse greater than 100, fever, sweating and agitation.
The best indicator of the effectiveness of replacement therapy is that blood TSH is constant and within the normal range.