DASAR DIAGNOSIS

HYPERTHYROIDii
 Symptoms

• Palpitations
• Heat intolerance
• Nervousness
• Insomnia
• Breathlessness
• Increased bowel movements, diare
• Light or absent menstrual periods
• Fatigue

• Symptoms = Yang Px Rasakan

 Sign
• Fast heart rate
• Trembling hands
• Weight loss
• Muscle weakness
• Warm moist skin
• Hair loss
• Enlarged thyroid gland - often accompanied by
feeling of fullness in the neck
• Staring gaze = membelalak ( exophthalmus )

• Sign = Tanda-tanda fisik

• Most people with hyperthyroidism do not
have all the symptoms and signs , but a
combination of two or more is common.
• Symptoms usually develop slowly over a
number of weeks or months.
• become worse as the level of thyroxine in the
blood gradually rises.
Diagnostic Workup
 Graves’ Disease
• exophthalmos
• Diffuse goiter. Graves' disease is the most
common cause of diffuse goiter.
• fatigue, weight loss with increased appetite, and
other symptoms of hyperthyroidism:
– rapid heart beats (rapid heart rate: 100-120 beats per
minute, or higher)
– Palpitations
– Arrhythmia (irregular heart beat)
– Raised blood pressure (Hypertension)
• Tremor (usually fine shaking, e.g., hands)
• muscular weakness
• a non-pitting edema (pretibial myxedema),
with thickening of the skin usually found on
the lower extremities

– “Gambaran klinik klasik dari penyakit graves

antara lain adalah tri tunggal hipertitoidisme,
goiter difus dan eksoftalmus.”
 Lab Exam
• TSH Test -- usually low to undetectable. (Note:
The low end of the TSH range is controversial.
The new, recommended low is 0.3, but many
doctors and most labs are still using the older,
outdated bottom range number of 0.5.)
• T4/Free T4 Test -- Normal to High
• T3/Free T3 Test -- Normal to High
• Radioactive Iodine Uptake (RAI-U) -- elevated.
American Association of Clinical
Endocrinologists
DIFFERENTIAL DIAGNOSIS

Toxic multinodular goiter; Plummer's

disease
 OVERVIEW
• Symptoms are those of hyperthyroidism.
However, the bulging eyeballs seen in

Graves disease do not occur.

 Perbedaan secara Fisik
Graves’ Disease Plummer’s Disease
Exophthalmos No
Diffuse goiter Show one or many nodules in the thyroid.
other symptoms of hyperthyroidism other symptoms of hyperthyroidism
 The difference Of the Lab Exam
Disease TSH Test T4/Free T4 Test T3/Free T3 Test Radioactive
Iodine Uptake
(RAI-U)
Graves low Normal to High Normal to High elevated
Plummer low high high increased