case internal medicine discussion 1-6.pptx

Med

1. Case discussion Done by dr ; Amna omar Under supervision of professor Mohamed Hesham

2. Analysis 24 years old Vaginal delivery 2months back Past history normal Sudden onset of symptonms 1 wk ago Symptoms;nervousness,heat intolerance,tremors T.S.H low (0.05 m.i.u /ml

3. Q1; what is most likely diagnosis? 1.pregnancy. 2. Thyrotoxicosis 3.Autoimmune thyroiditis Graves disease., hashimotos thyroiditis. 4.Post partum thyroiditis Q2 .what is next step? History,examination Investigation

4. Q3 .what is most likely mechanism of this process? Q4 .what is risk factor of this condition ? Q5 .what is complications of this condition ? Q6 .what is best therapy of this condition ? Q7 .how you confirm the diagnosis?

5. Post partum thyroiditis Incidence5-7% symptoms phases Treatment;

6. Post partum thyroiditis phases -In classical form Thyrotoxic phase Hypothyroid phase of PP

7. What symptoms are associated with PPT? -Mostly asymptomatic during the thyrotoxic phase (irritability, heat intolerance, fatigue, and palpitations). -Commonly symptomatic in the hypothyroid phase (cold intolerance, dry skin, lack of energy, impaired concentration, and aches and pains). -The occurrence of thyroid dysfunction in the first postpartum year in women who were euthyroid prior to pregnancy -Its occurrence reflects rebound of the immune system in the postpartum period . -It is an autoimmune disorder associated with presence of thyroid antibodies (TPO and Tg antibodies), lymphocyte abnormalities, complement activation, increased natural killer cell activity, and specific HLA haplotypes.

8. Prognosis 3-4% remains hypothyroidism 10-25% recurrent p.p.t 20-40% with T.P.O ab will developed permenant hypothyroidism

9. THANK YOU