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What disease relates to hyperthyroidism?
Graves' disease
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How is the level of T3 (triiodothyronine) and T4 (thyroxine) in hyperthyroidism pt?
Excess of T3 and T4 in blood
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How hyperthyroidism affect skeletal system?
- Increase bone turnover
- -> rate of resorption exceeds rate of formation
- -> osteoporosis
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How hyperthyroidism affects cardiovascular system?
Tachycardia, arythemia, congestive heart failure, angina, myocardial infarction
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How heyperthyridism affects central nervous system?
Anxiety, impared concentration, sleep disturbance, tremors (of hands, fingers, tongue)
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How hyperhyroidism affects to the eyes?
exophthalmos
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Three potential problems of hyperthyroidism...
- 1. Thyroid strom
- 2. very sensitive to catecholamine
- 3. risk of hypertension and sever arrhythmias
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What happens in thyroid strom?
- 1. high fever (39-40c)
- 2. tachycardia, arrythmias
- 3. tremor, sweating
- 4. คลื่นไส้ อาเจียน ท้องเดิน
- 5. stupor, coma, death
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Four factors that initiate thyroid strom?
- Trauma
- Infection
- Surgical procedure
- stress
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Dental management for pt with uncontroled hyperthyroidism?
- treat acute infection (ABO, drainage)
- avoid surgical procedure
- avoid epinephrine use
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Dental management for pt with well-controled hyperthyroidism?
- treat acute and chronic infection
- can implemant normal treatment procedure
- can use epinephrin (carefully)
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What happens with pt with hypothyrooidism?
What are specific name of the condition in child and adult patient?
- An insufficient prodution of thyroxine (T4)
- Child- cretinism
- Adult- myxedema
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Signs and symptoms of hypothyroidism?
- Decrease in metabolic rate:
- - cold intolerance, dry skin
- - fatigue, sleepy
- - weight gain, edema
- - slow in mental and phyusical processing
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Dental management for DM patient with good medical management?
Can implement normal treatment procedure
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Dental management for DM patient who are untreated or poorly treated?
- Avoid surgical procedure
- Avoid CNS depressant (narcotics, barbiturate)
because they will initiate myxedema coma
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What happens when Pts have myxedema coma?
- ซึม ไม่รู้สึกตัว
- Hypoventilation
- Hypothemia
- Bradycardia
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What medication should you use when pt has myxedema coma?
100-300 mg Hydrocortisone
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