Presus 3 Hipertiroid Dr Sibli

7/25/2019 Presus 3 Hipertiroid Dr Sibli

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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(%

Presus 3 Hipertiroid Dr Sibli

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