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Gambaran klinis

Riwayat penyakit dahulu pasien mencakup tirotoksikosis atau gejala-gejala seperti :iritabilitas,
agitasi, labilitas emosi, nafsu makan kurang dengan berat badan sangat turun, keringat berlebih
dan intoleransi suhu, serta prestasi sekolah yang menurunakibat penurunan rentang perhatian.
Riwayat penyakit sekarang yang umum dikeluhkan oleh pasien adalah demam, berkeringat
banyak, penurunan nafsu makandan kehilangan berat badan. Keluhan saluran cerna yang sering
diutarakan oleh pasienadalah mual, muntah, diare, nyeri perut, dan jaundice.
Sedangkan keluhan neurologik mencakup gejala-gejala ansietas (paling banyak pada remaja tua),
perubahan perilaku,kejang dan koma.
2 Pada pemeriksaan fisik, ditemukan demam dengan temperatur konsisten melebihi38,5oC.
Pasien bahkan dapat mengalami hiperpireksia hingga melebihi 41oC dankeringat berlebih.
Tanda-tanda kardiovaskular yang ditemukan antara lain hipertensidengan tekanan nadi yang
melebar atau hipotensi pada fase berikutnya dan disertaisyok. Takikardi terjadi tidak bersesuaian
dengan demam. Tanda-tanda gagal jantungantara lain aritmia (paling banyak supraventrikular,
seperti fibrilasi atrium, tetapitakikardi ventrikular juga dapat terjadi). Sedangkan tanda-tanda
neurologik mencakupagitasi dan kebingungan, hiperrefleksia dan tanda piramidal transien,
tremor, kejang,dan koma. Tanda-tanda tirotoksikosis mencakup tanda orbital dan goiter.
Selain kasus tipikal seperti digambarkan di atas, ada satu laporan kasus seorang pasiendengan
gambaran klinis yang atipik (normotermi dan normotensif) yang disertai olehsindroma disfungsi
organ yang multipel, seperti asidosis laktat dan disfungsi hati, dimana keduanya merupakan
komplikasi yang sangat jarang terjadi. Kasus inimenunjukkan bahwa kedua sistem organ ini
terlibat dalam krisis tiroid dan pentinguntuk mengenali gambaran atipik ini pada kasus-kasus
krisis tiroid yang dihadapi.

Symptoms could include:

Fever

Definition
Fever is the temporary increase in the body's temperature, in response to some disease or illness.
A child has a fever when their temperature is at or above one of these levels:

100.4 F (38 C) measured in the bottom (rectally)


99.5 F(37.5 C) measured in their mouth (orally)

99 F (37.2 C) measured under their arm (axillary)

An adult probably has a fever when their temperature is above 99 - 99.5 F (37.2 - 37.5 C),
depending on what time of the day it is.
Read more: http://www.healthline.com/adamcontent/fever#ixzz1IW3hAoQ6
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Shock

Definition
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow.
This can damage multiple organs. Shock requires immediate medical treatment and can get
worse very rapidly.

Considerations
Major classes of shock include:

Cardiogenic shock (associated with heart problems)


Hypovolemic shock (caused by inadequate blood volume)

Anaphylactic shock (caused by allergic reaction)

Septic shock (associated with infections)

Neurogenic shock (caused by damage to the nervous system)

Read more: http://www.healthline.com/adamcontent/shock#ixzz1IW3q83Mw


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Palpitations

Definition
Palpitations are heartbeat sensations that feel like your heart is pounding or racing. You may
simply have an unpleasant awareness of your own heartbeat, or may feel skipped or stopped
beats. The heart's rhythm may be normal or abnormal. Palpitations can be felt in your chest,
throat, or neck.

Confusion

Definition
Confusion is the inability to think with your usual speed or clarity, including feeling disoriented
and having difficulty paying attention, remembering, and making decisions.
Read more: http://www.healthline.com/adamcontent/confusion#ixzz1IW4ZOd6A
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Restlessness

Definition
Agitation is an unpleasant state of extreme arousal, increased tension, and irritability.

Alternative Names
Restlessness

Considerations
Extreme agitation can lead to:

Confusion
Hostility

Hyperactivity

Agitation can come on suddenly or over time. It can last for just a few minutes, or for weeks and
even months. Pain, stress, and fever can all increase agitation.

Agitation by itself may not be a sign of a health problem. However, if other symptoms occur, it
can be a sign of disease.
When agitation lasts for hours and there is changed awareness (altered consciousness), doctors
often call this "delirium." Usually this has a medical cause such as alcohol withdrawal or an
infection (in elderly adults). Older adults often have delirium while hospitalized.

Diaphoresis

Trembling

Moist Skin

Definition
Moist skin is skin that feels slightly wet or damp to the touch..

Alternative Names
Wet skin, skin wetness, dampskin.

Synopsis
Moist skin is an indication that the body is sweating (perspiring). Perspiration is the release of
liquid from the sweat glands of the body, a normal body function to help the body stay cool. We
are born with two to four million sweat glands and we sweat more in hot environments, when we
exercise or when we are nervous, embarrassed or frightened. If, however, the skin is generally
moist from sweat in absence of these conditions, and accompanied by weight loss, fever,
shortness of breath, chest palpitations, chest pain or other symptoms, it may be an indication of
an underlying medical condition.

Associated Diagnoses

Hyperthyroidism
Menopause

Arthritis

Alcohol intake

Caffeine consumption

Heart disease

Anxiety

Infection

Low blood sugar

Withdrawal from narcotics

AIDS

Graves disease

Spinal cord injury

Panic attack

Pain

Cancer

Pulmonary embolism

High blood pressure

Read more: http://www.healthline.com/hlc/moist-skin#ixzz1IW5SwJmW


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Fast Heart Rate

Definition

The heart rate is the number of beats (rhythmic contractions) per minute of the heart (the
muscular organ in the center of the chest that maintains circulation of the blood) and is a
measure of cardiac activity. A fast heart rate is greater than 100 beats per minute for an
adult or child at rest, greater than 120 beats per minute for an infant (age one month to
one year), and greater than 160 beats per minute for a newborn under one month old.

Alternative Names
Heart rate increased, heartbeats increased, high heart rate, increased heart rate, pulse fast,
pulse rate increased, rapid heart rate, rapid heartbeat, rapid pulse, tachycardia.

Read more: http://www.healthline.com/hlc/fast-heart-rate#ixzz1IW5HU7QK


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Abnormal Heart Rhythms

Definition

Moist skin is skin that feels slightly wet or damp to the touch..

Alternative Names
Wet skin, skin wetness, dampskin.

Synopsis
Moist skin is an indication that the body is sweating (perspiring). Perspiration is the release of
liquid from the sweat glands of the body, a normal body function to help the body stay cool. We
are born with two to four million sweat glands and we sweat more in hot environments, when we
exercise or when we are nervous, embarrassed or frightened. If, however, the skin is generally
moist from sweat in absence of these conditions, and accompanied by weight loss, fever,
shortness of breath, chest palpitations, chest pain or other symptoms, it may be an indication of
an underlying medical condition.

Associated Diagnoses

Hyperthyroidism
Menopause

Arthritis

Alcohol intake

Caffeine consumption

Heart disease

Anxiety

Infection

Low blood sugar

Withdrawal from narcotics

AIDS

Graves disease

Spinal cord injury

Panic attack

Pain

Cancer

Pulmonary embolism

High blood pressure

Read more: http://www.healthline.com/hlc/moist-skin#ixzz1IW5SwJmW


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Alteration In Consciousness

Definition
Decreased consciousness is reduced alertness or awareness.

Alternative Names
Stuporous; Mental status - decreased; Loss of alertness; Decreased consciousness; Alertness decreased; Changes in consciousness; Obtundation; Coma; Unresponsiveness

Considerations
A persistent coma is called vegetative state.

Common Causes
Many conditions can cause decreased consciousness, including:

Alcohol intoxication
Drug intoxication (particularly opiates, narcotics, sedatives, and anti-anxiety or seizure
medications)

Arrhythmia

Brain disorders

Central nervous system diseases

Lack of oxygen (hypoxia)

Abnormal blood sugars (diabetic coma)

Electrolyte or mineral imbalance

Exposure to heavy metals or hydrocarbons

Extreme fatigue or sleep deprivation

Ketoacidosis

Head trauma

Heart failure

Hypoglycemia (low blood sugar)

Increased carbon dioxide levels (hypercarbia) often seen in emphysema

Infection

Low blood pressure (hypotension)

Metabolic disorders

Thyroid or adrenal gland disorders

Seizures such as those related to epilepsy

Shock

Stroke

Read more: http://www.healthline.com/adamcontent/consciousness-decreased#ixzz1IW81FYR4


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Fluttering Heart

Definition

Alternative Names

Fluttering heart is the heart beating in a noticeable pattern, usually irregular. The strict
definition of "atrial flutter" refers to a specific definition of how the atria (upper
chambers) of the heart beat in a type of irregular rhythm, and can only be diagnosed with
an electrocardiogram ("heart tracing").
Fluttering in chest, heart flutter, palpitations- fluttering.
Read more: http://www.healthline.com/hlc/fluttering-heart#ixzz1IW87IOPx
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Hard to Awaken

Feels Hot to Touch

Definition:

The body is hotter than normal body temperature when touched.

Alternative Names:
Feverish, feel hot, feeling hot, feels hot and feverish, hot to touch

Synopsis
Sometimes a person feels hot to touch due to illness or environmental situation that causes
elevated core temperature. A compounding factor can be dehydration (lack of fluids. In any case,
it is important to determine if the person has elevated body temperature caused by a fever (use a
thermometer to determine the persons temperature). If a fever (often caused by an infection like
a virus) is present, it may be treated with fluids and over-the-counter anti-inflammatory
medications like acetominophen or ibuprofen. Aspirin should not be used to treat fever in anyone
under age 17 years or younger. None of these drugs should be used to treat environmental heat
illness. The very young, very old and obese people are especially vulnerable to dehydration so it
is important to make sure they are taking in enough fluids during the day, and protected from
extremely hot environmental temperatures.

Heart Rate Altered

Definition
The heart rate is the number of beats (rhythmic contractions) per minute of the heart (the
muscular organ in the center of the chest that maintains circulation of the blood) and is a measure
of cardiac activity.

Alternative Names
Heart rate changed, changes in heart rate, pulse rate changed
Read more: http://www.healthline.com/channel/thyroid-crisis_symptoms#ixzz1IW2SJcVk
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Krisis tiroid
Tyroid storm
-meninkatnya metabolism

-Meningkatnya produksi panas


-takikardi
-meningkatnya kontraktilitas miokard yg terjadi sebagai respon akibat stimulasi
kardio oleh tiroid
-perubahan status mental (bingung, psikosis, agitasi, koma