GOITRE
-
Upload
muhammad-nasrullah -
Category
Health & Medicine
-
view
68 -
download
0
Transcript of GOITRE
![Page 1: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/1.jpg)
GOITRE
Disediakan Oleh : NassrutoDisediakan Oleh : Nassruto
![Page 2: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/2.jpg)
DEFINASIDEFINASI
• Istilah yang digunakan untuk sebarang keadaan pembesaran kelenjar tiroid.
• Perempuan > lelaki.
![Page 3: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/3.jpg)
![Page 4: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/4.jpg)
ETIOLOGIETIOLOGI• Fisiologikal – perempuan yg baligh
atau hamil.• Auto-imun – Penyakit Grave’s &
Hashimoto.• Thyroiditis – ‘de Quervain’s
Thyroiditis’ atau ‘Reidel’s Thyroiditis’• Simple goitre - iodin dlm diet
(goiter endemik).
![Page 5: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/5.jpg)
ETIOLOGIETIOLOGI
• Goiter nodul berganda (multinodular goiter).
• Tumor – adenoma, karsinoma, limfoma.
![Page 6: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/6.jpg)
Patofisiologi
![Page 7: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/7.jpg)
![Page 8: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/8.jpg)
PATOFISIOLOGI(simple PATOFISIOLOGI(simple Goitre)Goitre)
• Kekurangan Iodin - diet.• sintesis T3 & T4 oleh kelenjar tiroid.• hormon TSH oleh kelenjar pituitari
akibat hormon T3 & T4 dalam darah.• Proses diatas berterusan dan
menyebabkan kelenjar tiroid menjadi hipertropi & hiperplasia.
• Pembesaran kelenjar tiroid.• Lihat gambarajah 25-10.
![Page 9: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/9.jpg)
PATOFISIOLOGI
![Page 10: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/10.jpg)
MANIFESTASI MANIFESTASI KLINIKALKLINIKAL• Pembesaran kelenjar tiroid• Kelenjar mungkin sakit atau tidak sakit.• Disfagia – jika berlaku tekanan pada
esofagus.• Sesak nafas – jika berlaku tekanan pada
trakea.• Baligh atau hamil – kelenjar tiroid
mungkin membesar secara berselerak (diffuse).
![Page 11: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/11.jpg)
MANIFESTASI MANIFESTASI KLINIKALKLINIKAL
• Grave’s diseaseGrave’s disease – kelenjar tiroid
membesar secara berselerak, pejal & auskultasi terdapat “bruit’.
![Page 12: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/12.jpg)
MANIFESTASI MANIFESTASI KLINIKALKLINIKAL
• Simple Goitre –Simple Goitre – kelenjar tiroid
membesar, licin & lembut.
![Page 13: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/13.jpg)
MANIFESTASI MANIFESTASI KLINIKALKLINIKAL
• Nodular goitre –Nodular goitre – • mungkin nodul
berganda atau tunggal.
• Kerap berlaku pd warga tua.
• Penyebab utama tekanan pd esofagus & trakea.
![Page 14: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/14.jpg)
MANIFESTASI MANIFESTASI KLINIKALKLINIKAL• Thyroiditis akut (de Quervain’s) –Thyroiditis akut (de Quervain’s) –
kelenjar tiroid membesar secara berselerak, tender & amat sakit.
• Nodul Tunggal (solitary Nodul) –Nodul Tunggal (solitary Nodul) – mungkin karsinoma tiroid sekiranya terdapat kesakitan, pembesaran tiroid yg cepat & disertai dgn pembesaran nodus limfa.
![Page 15: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/15.jpg)
PENYIASATAN
• Ujian Fungsi Tiroid• Paras TSH – normal (0.23-3.8mU/L)• Paras Hormon Tiroid (T3 & T4)• Normal T3 (Triiodotironinie) – 1.3-3.1nmol/L• Normal T4 (thyroxine) - 66-181nmol/L
• X-Ray Dada – kesan tekanan pd trakea & perubahan kedudukan trakea.
![Page 16: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/16.jpg)
PENYIASATAN
• Ultra Sound Scan Tiroid – tentukan kawasan ‘sejuk’ tunggal pd skan radionuklid bersista dgn sepenuhnya (benign) atau sebahagian shj yg bersista (malignan)
• Fine-needle biopsy – kajian histologi.
![Page 17: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/17.jpg)
PENGURUSAN DAN RAWATAN
• Goitre pd prkt baligh atau hamil – jarang memerlukan rawatan. Jika pt didapati eutiroid – sembuh sendiri.
• Pembedahan atas sebab-sebab berikut;• Malignan• Tekanan keatas trakea atau Esofagus.• Kosmetik.
![Page 18: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/18.jpg)
Tirodektomy
![Page 19: GOITRE](https://reader035.fdocumento.com/reader035/viewer/2022070510/58a637f41a28ab68118b54a5/html5/thumbnails/19.jpg)