四川大学华西临床医学院：甲状腺疾病（PPT课件讲稿）Thyroid Diseases

Thyroid Diseases West China Hospital of sichuan Univesity Sichuan University West China School of Medicine Department of Internal Medicine Division of Endocrinology and Metabolism Wangqin(王覃),MD 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Thyroid Diseases West China Hospital of Sichuan Univesity Sichuan University, West China School of Medicine Department of Internal Medicine Division of Endocrinology and Metabolism Wangqin (王覃), MD

Part 1 Classification of Thyroid Diseases 1. Congenital: Enzyme deficiency, abnormal development (structure, location, morphology pregnant woman(gestational)-associated 2. Clinical manifestation overt subclinical 3. Function: Hyperfuntion thyrotoxicosis hyperthyroidism Hypofunction- hypothyroidism 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Part 1 Classification of Thyroid Diseases 1. Congenital: Enzyme deficiency, abnormal development (structure, location, morphology), pregnant woman(gestational)- associated....... 2. Clinical manifestation: overt subclinical 3. Function: Hyperfuntion- thyrotoxicosis ≠ hyperthyroidism Hypofunction- hypothyroidism

Part 1 Classification of thyroid diseases 4. Morphology and structure enlargement (goiter) atroph mass or nudule 5. Localization ectopic 6. Pathogenesis: autoimmune-AlTD non-autoimmune- non-AITD 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Part 1 Classification of Thyroid Diseases 4. Morphology and structure: enlargement (goiter) atrophy mass or nudule 5. Localization: ectopic 6. Pathogenesis: autoimmune- AITD non-autoimmune- non-AITD

Part 1 Classification of thyroid diseases 7. Diseases AThyroiditis fulminant acute infection radiation subacute: pain(granulomatous painless(lymphocytic chronic: Hashimoto(chronic lymphocytic) Riedel(fibrotic 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Part 1 Classification of Thyroid Diseases 7. Diseases: A.Thyroiditis￾fulminant acute: infection, radiation subacute: pain (granulomatous) painless(lymphocytic) chronic: Hashimoto (chronic lymphocytic) Riedel(fibrotic)

Part 1 Classification of thyroid diseases 7. Diseases. B. simple goiter C. Graves disease(thyroiditis D tumor E ectopic E tuberculosis G trauma and injury 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Part 1 Classification of Thyroid Diseases 7. Diseases: B. simple goiter C. Graves disease(thyroiditis?) D. tumor E. ectopic F. tuberculosis G. trauma and injury

Part 1 Classification of thyroid diseases 8. latrogenic 9. Factitious 10.others. A abnormal metabolism of thyroid hormones euthyroid sickness syndrome, non- thyroid illness syndrome..) B thyroid hormone resistance(T3-R B mutation C. TSH resistance D. tSh gene mutation E TSH-R gene mutation 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Part 1 Classification of Thyroid Diseases 8. Iatrogenic 9. Factitious 10.others: A. abnormal metabolism of thyroid hormones (euthyroid sickness syndrome, non- thyroid illness syndrome……) B. thyroid hormone resistance(T3-R ß mutation) C. TSH resistance D. TSH gene mutation E. TSH-R gene mutation … …

Feedback control of thyroid hormone Feedback control of thyroid hormones The hypothalamus, a r hypothalamus TRH causes another part portion of the brain of the brain, the pituitary releases TRH TrH gland, to secrete TSH (thyrotropin releasing 〔 thyroid stimulating hormone hormone) pituitary gland TSH stimulates the TSH thyroid gland to produce the thyroid hormones T4 and t3, which are release thyroid gland into the bloodstream Thyroid hormone T4 +circulate in the blood to all the organs of Organs If the thyroid hormone level in the blood drops the pituitary gland senses it, releases more TSH and the cycle of thyroid hormone production continues 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Feedback control of thyroid hormone

Part 2: Thyrotoxicosis and Hyperthyroidism 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Part 2: Thyrotoxicosis and Hyperthyroidism

What is thyrotoxicosis? a clinical condition or syndrome encompassing several specific diseases, clinically characterized by hypermetabolism, and biochemically elevated or inappropriate high serum levels of free thyroid hormones and their action in tissue, includes hyperthyroidism as one cause 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 What is thyrotoxicosis? A clinical condition or syndrome encompassing several specific diseases, clinically characterized by hypermetabolism, and biochemically elevated or inappropriate high serum levels of free thyroid hormones and their action in tissue, includes hyperthyroidism as one cause

Task 1 ■请根据甲状腺素的生理功能,推理甲状腺素过多和 过少会产生什么样的临床表现(时间10分钟,讨论 5分钟+参观5分钟) ■形式:分4-6组讨论,选择一名同学为秘书做记录。 将讨论结果(要求以短语形式)写在一张A3大小的 纸上面(分成两半,一半甲亢一半甲减),然后按 照顺时针顺序进行换组参观,参观时需要把补充或 不同的意见以不同颜色的笔标记在纸上(尽量以生 动模式进行,比如画画) 华窗脑床原学院內分跳代鷺科

华西临床医学院内分泌代谢科 Task 1 请根据甲状腺素的生理功能，推理甲状腺素过多和 过少会产生什么样的临床表现（时间10分钟，讨论 5分钟+参观5分钟） 形式：分4-6组讨论，选择一名同学为秘书做记录。 将讨论结果（要求以短语形式）写在一张A3大小的 纸上面（分成两半，一半甲亢一半甲减），然后按 照顺时针顺序进行换组参观，参观时需要把补充或 不同的意见以不同颜色的笔标记在纸上（尽量以生 动模式进行，比如画画）