By: Ricky

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By : Ricky

 Seorang perempuan datang dengan keluhan terdapat benjolan di leher sejak 1

tahun yang lalu. Keluhan nyeri (-), berdebar-debar (-). Pada pemeriksaan fisik didapatkan benjolan dileher yang ikut bergerak saat menelan. Pemeriksaan penunjang yang mendukung penegakan diagnosis adalah a. Iodin serum

b. Iodin tiroid c. TSH, T4, FT3 d. TSH, T4, FT3, Anti-thyroglobulin e. TSH, FT4

Hipertiorid – Hipotiroid Transport

Organifikasi

(+) Thyroxine Binding Globulin

Coupling

Storage

Secretion

TSH Decreased

Normal

Increased

FT4 Decreased

Normal

FT4

Increased

Central Subclinical Hypothyroidism Hyperthyroidism

Decreased

Primary Hyperthyroidism

Normal

Primary Hypothyroidism

Increased

Subclinical Hypothyroidism

RAIU Diffuse Homogeneous Grave’s Disease

Focal

Heterogeneous

Toxic Multinodular Goiter

TSH-secreting Adenoma (central Hyper-T) Or (T- hormone resistance)

None Functioning Adenoma

Serum Thyroglobulin

Decreased Thyrotoxicosis Factitia

Increased Thyroiditis struma ovani

 Pasien mengalami penurunan kesadaran, memiliki riwayat DM, terapi saat ini

diberiksan glibenklamid dan metformin. Pasien sebelumnya merasa malu lalu tidak makan. Obat terus dilanjutkan, GDS 40 g/dL. Terapi yang tepat adalah? a. Glikogen 1 mg intramuscular b. Glikogen 1 mg intavena c. D40 3 flacon d. D40 2 facon e. D40 1 flacon

 Keadaan  GD < 60mg/dL, atau 80mg/dL dengan gejala klinis.  Etiologi :  Dosis OHO  insulin, sulfonilurea  Post partum, GGK

 Intake inadekuat

 Dx  Trias Whipple  Gejala yang konsisten dengan hipoglikemia  Kadar glukosa rendah  Gejala menghilang jika GD meningkat

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