GLANDA TIROIDA - curs

  • Published on
    13-Nov-2014

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Transcript

GUA ENDEMIC/SPORADICPRODUCIE INSUFICIENT (IOD) Consum prea rapid Eutiroidian

COMPLICAII compresia

infecia hemoragia hipo/hipersecreia

SEMNE CLINICE tiroidiene

cardiovasculare metabolice nervoase oculare

PARACLINIC iodemie colesterol metabolism bazal reflexogram radioiodocaptare T3 T4

TRATAMENT ATS : tiouracil/carbimazol iod radioactiv chirurgical: - pregtire operatorie - moment operator TIROIDECTOMIE SUBTOTAL

COMPLICAII hemoragie paralizie nerv recurent tetanie mixedem cuiza tireotoxic persistena exoftalmiei

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GUA HIPERTIROIDIZAT

- ADENOM TOXIC Tratament chirurgical

DIFERENIAT

- papilar 85% - folicular 15% ANAPLAZIC MEDULAR (din celule parafoliculare) SARCOM (din esutul conjunctiv)

AMAMNEZ

(iradiere ?)

CLINIC: intra/extracapsular PUNCIE BIOPSIE ECOGRAFIE SCINTIGRAM EXAMEN ORL

RISK AGE META EXTENT SIZE

LOW < 50 intracapsular < 5 cm

HIGH > 50 + extracapsular > 5 cm

DIFERENIAT tiroidectomia (sub) total disecia ganglionar iod radioactiv

ANAPLAZIC tiroidectomie total radio/chimioterapie fr efect prognostic foarte negativ

MEDULAR tiroidectomie total disecie ganglionar urmrire postoperatorie

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