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Presentasi Kasus
HIPERTIROIDISME
OLEH :AZIZAH RIDWAN 110.2009.050
PEMBIMBING :
Dr. HAMI ZULKIFLI ABBAS, Sp.PD, MH.KeDr. S!IBLI, Sp.PD
Dr. SUNHADI
KEPANI#ERAAN KLINIK ILMU PEN!AKI# DALAM
RSUD AR$AWINANGUN
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HIPERTIROIDISME
D%&e'() *+( e-((% %r//&%&/%,%per%r/%%e %e3'%%&('e-((% rep/' *(r%'('4*(r%'('+-+ er((p pe'(r+
e(-/)%& /r/' %r/% ('-er)e-%('. Ke(((' %'% (p(%-+) p/'(' ((+ (&%-( (+p('/r/' %r/% e6(r( -er)e-%('.
A( 2 %pe %per%r/%%e p/'(':
1. Pe'(&% Gr(7e
2. G/%er N/+)(r #/&%&
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E#IOLOGI
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PA#OGENESIS
H%per%r/%%e p(( pe'(&%
Gr(7e (()( (&%-(('%-/%reep/r r/% %+)(%'
/r/' 8#SH (' er('('(&%7%( %r/%, e('&(' p((/%er +)%'/+)(r /&%&-er+-+'(' e'(' ('(/% %r/%
%+ e'%r%. A(p+)( %per%r/%ee-((% (&%-( pe'%'&((' e&re%
#SH (r% %p/3%, '(+' *(r('%e+&('.
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H%per%r/%%e p(( # %r//&%&/%
+'&%' %(&%-(&(' /)e e%/'%(% #;
p(( %r/% ((+ e'%'&('( #
*(r%'(' %)+(r %r/%. P((%r//&%&/% (' %(& %er(%%per%r/%%e eper% %r/%%% er*(%&e-/6/r(' /r/'. M(+&(' /r/'
%r/% (r% )+(r (' -er)e-%(' ('er(p('( *(r%'(' %r/% e&/p%&(p( e'(&%-(&'( %r//&%&/%('p( %per%r/%%e.
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MANIFES#ASI KLINIK
H%pere(&%7%(, p()p%(%,
-er( -((' e'+r+', '(
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KASUS
N(( : #'. AK $e'% Ke)(%' : L(&%4)(&%
U+r : 50 #(+'
A)(( : ?%(@%, P()%@(' Pe&er*((' : Pe(('
A(( : I)(
S(+ Per&(@%'(' : Me'%&( #). M(+& : 0;404201
#). Ke)+(r : 0404201
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KELUHAN UTAMA
Me'6re e*(& (r% SMRS.
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RIWAYAT PENYAKIT SEKARANG
P(%e' ((' &e RSUD Ar*(@%'('+'e'(' &e)+(' e'6re e*(& (r%SMRS. P(%e' e'e)+ er%' BABe'(' &/'%e'% 6(%r e'('
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P(%e' *+( e'(&+ er%'
&e)+(r &er%'( p(( ()((r% (' ('(' (' ee(r.Ke)+(' %'% %r((&(' +((p%r 1 (+' (' )()+.
Ke)+(' %(& %er(% e'('r(( +() (' +'(. P(%e'
*+( er(( -/)( (( er((
e'/'*/) &e (r( )+(r. P(%e'e'(&+ -er( -((''( +r+'0 & e'*(% ;9 &. BAK'/r().
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RIWAYAT PENYAKIT DAHULU
P(%e' e'(&+ %(& per'(
e'er%( pe'(&% er+p(e-e)+'(. P(%e' %(&e%)%&% r%@(( (&% p('(%'% e-e)+'(. P(%e' %(&e%)%&% r%@(( %pere'% ('
(&% &+'%' e-e)+'(. P(%e'*+( %(& e%)%&% r%@((()er% pe(&(%(' /-(4/-(('(' (&('(' e-e)+'(.
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RIWAYAT PENYAKIT KELUARGA
P(%e' e'(&+ %(& ((
('/( &e)+(r( ('e'er%( pe'(&% er+p(,
%pere'%, (&% *('+',%'*(), &e'6%' ('% ('()er%.
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RIWAYAT SOSIO EKONOMI
P(%e' %'() -er(( %r%
(' &e+( ('(&'(. P(%e'
-e&er*( e-((% pe(('&(&% )%(. P(%e' -er/-( &eRS Ar*(@%'('+' e'('e'+'(&(' &(r+
$AMKESMAS.
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PEMERIKSAAN FISIK
Ke((r(' : ?/p/ e'% #e&('(' (r( : 1;0 = 90 H
N(% : 100 = e'%, re+)er,
&+(, pe'+ Per'(p((' : 2; = e'%,
%p'e+ 8
S++ : .50 ?
#+r/r &+)%: B(%&
#%'% B((' : 1 6
Ber( -((' : ;9 K
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KEPALA
Be'+& : N/r(), %er%
R(-+ : H%(, %(& +(%6(-+
M(( : Exophtalmus + / + K/'*+'%7( %pere%
S&)er( %(& %&rer%&
Ee( p()pe-r( 84 P+p%) %/&/r &('(' &%r%
Re>e&% 6((( 8
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#e)%'( : Be'+& '/r(),%er%, e-r('%p('% %'(&
H%+' : Be'+& '/r(),ep+ % e'(, %(&e7%(%
M+)+ : B%-%r %(&%('/%, )%( %(&&//r, %(& %pere%
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Leer : Terdapat
pembesaran kelenjartiroid sebelah kanan
#%(& er(p( e7%(%r(&e(
#%(& er(p(pe-e(r(' KGB
$P %(& e'%'&(
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THORAKS
I'pe&% : Be'+& (( &('(' &%r% %er%
perer(&(' '(p( &('('
&%r% I&+ &/r% %(& (p(&
Sp%er '(e7% 84
P()p(%: Fre%+ (&%) &('(' &%r%
I&+ &/r% er(-( % e)(
%( (r% %6)(7%6+)( &%r%
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Per&+% : S/'/r p(( &e+( )(p('p(r+
B(( (( : e)( %( III (r%er'()% &('('
B(( &('(': e)( %( I (r%p(r(er'()% &('('
B(( &%r% : e)( %( (r%%&)(7%&+)( &%r%
B(( p(r+ (% : e)( %( I(r% %&)(7%&+)( &('('
A+&+)(%: Per'(p((' 7e%&+)er,R4=4, W 4=4, -+'% *('+' I4II
+r'%, re+)er, +r+r 84, ())/p 84
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ABDOMEN
I'pe&% : Per+ 6e&+' %er%
e'( &/)(er() 84
?(p+ Me+(e(-)
U-%)%&+ %(& e'/'*/)
P()p(% : Ner% e&(' (-/e' (-)
#%(& (( pe-e(r(' ep(r
#%(& (( pe-e(r(' )%e'
Per&+% : S%
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EKS#REMI#AS
S+per%/r : H('(
Tremor (+/+)
Er%e( p()(r% 84=4
S%('/% 84=4?)+--%' 3'er 84=4
Ee( 84=4
Per+&((' &+)% -(( 8
I'
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Peer%&((' Pe'+'*('Tanggal pemeriksaan 04-07-2013
LAB E!"LT "#$T #%&ALL$&$T!
WB?L!MMON
GRARB?HGBH?#M?M?H
M?H?PL#
;.2.11.9
0.5.11.259.2.;
.2150
10=L10=L10=L
10
=L10=)=)JND
=)10=)
;.0 = 12.01.0 = 5.00.1 = 1.0
2.0 = .0;.00 = .2011.0 = 1.05.0 = 55.00.0 = 100.02.0 = ;.0
1.0 = 5.5150 = ;00
#o 'emeriksaan asil &etode #ilai
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#o 'emeriksaan asil &etode #ilainormal
1.2..
1.2..;.5.
...9.
10.
K%%( &)%'%&F+'% %'*()
Ure+Kre(%'%'Ur%6 (6%
F+'% H(%
A)-+%'SGO#SGP#Pr/e%' /()G)/-+)%'
B%)%r+-%' /()B%)%r+-%' %re&B%)%r+-%' %'%re&A)&()% p/p((e
G)+&/(
G)+&/( e@(&+
20.;0.0.;;
,021.;;.2
0.950.0.51;
9
Ure(e U L%+%$(e ?/p S#A
B?G A%- p)+IF??2IF??2
104500.41..;4.0
.545.004,004;1.049.01.54.0
0.141.20.040.2540.50425
04150
=)=)=)
r=)U=IU=Ir=)r=)
=)=)=)U=I
=)
#o 'emeriksaan asil &etode #ilai
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#o 'emeriksaan asil &etode #ilainormal
1.2..;.5.
...9.
11.12.1.1;.15.1.
1.
K%%( &)%'%&Ur%' R+%'
W(r'(pHBer( $e'%N%r%Pr/e%'
G)+&/(Ke/'B%)%r+-%'Ur/-%)%'/e'
Se%e'
Le+&/%Er%r/%Ep%e)Kr%()B(&er%$(+r
S%)%'er
K+'%'.51.015Ne(%
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