Briefly describe the clinical manifestations of diffuse goiter with hyperthyroidism

The latter has no symptoms of hyperthyroidism; The thyroid uptake (131)i rate can be increased, but the peak of positive uptake does not move forward. The T3 inhibition test can be suppressed; normal or high T4, normal or high T3; normal or high TSH; TRH excitation test teaser normal; Erythrocyte sedimentation rate, TGAB and TPOAB are bisexual.

Main triggers: 1) stress state, such as infection, surgery, radioactive 131i**, etc.;

2) Severe physical diseases, such as congestive heart failure, hypoglycemia, sepsis, cerebrovascular accident, acute abdomen or severe trauma, etc.;

3) oral overdose of TH preparations;

4) severe mental trauma;

5) Excessive squeezing of the thyroid gland during surgery. Clinical manifestations: early manifestations are aggravation of the original symptoms of hyperthyroidism, followed by high fever (body temperature higher than 39), rapid cardiac content (140 240 minutes), often atrial fibrillation or atrial flutter; Irritability, sweating, shortness of breath, food aphobia, nausea, vomiting, diarrhea.

Patients suffer from profuse water loss, resulting in collapse, shock, drowsiness, delirium, or coma.

Answer]: b, c, d, e

This question examines hyperthyroidism. The clinical manifestations of patients with hyperthyroidism are: (1) polyphagia, weight loss, heat intolerance, excessive sweating, irritability, increased stool frequency or diarrhea, and infrequent menstruation in women.

2) Enhancement of nerve and cardiovascular excitability, such as hand tremor, tachycardia, heart murmur, and severe cases may have serious manifestations such as cardiomegaly, atrial fibrillation, and heart failure. (3) Characteristic signs of grasping and elimination such as goiter and proptosis of different degrees. (4) It can be accompanied by periodic paralysis (more common in Asian, young and middle-aged men) and progressive weakness and atrophy of proximal muscles.

5) In severe cases, thyroid storm, coma and even life-threatening may occur. (6) A small number of elderly patients have atypical hypermetabolic symptoms, but only manifest as fatigue, palpitations, anorexia, depression, drowsiness, and significant weight loss, which is called "apathetic hyperthyroidism". "Hoarseness, thinning hair, and loss of the outer ends of the eyebrows1 3" are clinical manifestations of hypothyroidism.

The clinical manifestations of thyroid gland crisis are: protruding hyperthermia, often more than 39, sometimes more than 40. Irritability, fear, delirium, and even coma.

The heart rate is usually more than 140 minutes, and in severe cases, it can reach 240 minutes, and it may be accompanied by atrial fibrillation or atrial flutter. Shortness of breath, sweating, nausea, vomiting, diarrhea, dehydration, and disturbances in water and salt metabolism are common. In severe cases, shock may occur.

Heart failure and pulmonary edema may occur.