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HIPERTIREOIDISMO ____________________________________
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FELINO ____________________________________
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ENDOCRINOLOGIA ____________________________________
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MSc. GUSTAVO DITTRICH ____________________________________
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HIPERTIREOIDISMO ____________________________________
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HIPERTIREOIDISMO ____________________________________
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DEFINIÇÃO ____________________________________
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» Presença de quantidades excessivas de ____________________________________
hormônios tireoidianos (T3 e T4) na circulação, ____________________________________
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que se manifesta por intensificação da ____________________________________
atividade metabólica do organismo ____________________________________
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EIXO ____________________________________
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Gato normal Gato com hipertireoidismo ____________________________________
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CAUSAS ____________________________________
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» Nódulos adenomatosos hiperplásicos ____________________________________
funcionais (98-99%) ____________________________________
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» Carcinomas tireoidianos (1-2%) ____________________________________
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CAUSAS ____________________________________
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»Aumento unilateral ____________________________________
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» 20-30% ____________________________________
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» Lobo contralateral atrofiado ____________________________________

»Aumento bilateral ____________________________________

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» 80% dos casos com assimetria ____________________________________
» 3-5% tecido ectópico hiperplásico ____________________________________
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(mediastino) ____________________________________
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EPIDEMIOLOGIA ____________________________________
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SINAIS CLÍNICOS ____________________________________
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SINAIS CLÍNICOS ____________________________________
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Sinais Clínicos Frequência (%) ____________________________________
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Emagrecimento 98 ____________________________________
Polifagia 67 ____________________________________
Dermatopatias 52 ____________________________________
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Polidipsia 45 ____________________________________
Diarreia 45 ____________________________________
Hiperatividade 34 ____________________________________
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Vômitos 33 ____________________________________
Poliúria 27 ____________________________________
Agressividade 20 ____________________________________
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Intolerância térmica 15 ____________________________________
Dispneia 13 ____________________________________
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SINAIS CLÍNICOS ____________________________________
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SINAIS CLÍNICOS ____________________________________
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SINAIS CLÍNICOS ____________________________________
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DOENÇAS ASSOCIADAS ____________________________________
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Cardiomiopatia hipertrófica ____________________________________
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VD ____________________________________
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Ao ____________________________________
VE ____________________________________
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AE
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Normal Hipertrofia ____________________________________
concêntrica ____________________________________
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DOENÇAS ASSOCIADAS ____________________________________
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Doença Renal Crônica ____________________________________
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Equilíbrio ácido- Equilíbrio ____________________________________
base eletrolítico ____________________________________
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Manutenção da Filtração do ____________________________________
PAS sangue ____________________________________
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Equilíbrio ____________________________________
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hídrico ____________________________________
Produção ____________________________________
hormonal ____________________________________
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DIAGNÓSTICO ____________________________________
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»Resenha, anamnese ____________________________________
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»Exame físico ____________________________________
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» Palpação de tireoide ____________________________________
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DIAGNÓSTICO ____________________________________
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» Resenha, anamnese ____________________________________
» Exame físico ____________________________________
» Palpação de tireoide ____________________________________
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» Hipertensão arterial ____________________________________
» Exames laboratoriais ____________________________________
» Hemograma ____________________________________
» Bioquímica sérica: azotemia, ↑ enzimas ____________________________________
hepáticas (ALT, FA, GGT) ____________________________________
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» Exames de imagem ____________________________________
» Avaliação da função tireoidiana: T4 total ____________________________________
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TRATAMENTO ____________________________________
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CLÍNICO
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CIRÚRGICO ____________________________________
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IODO RADIOATIVO ____________________________________

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TRATAMENTO ____________________________________
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»Clínico ____________________________________
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»Fármacos do grupo tiourileno ____________________________________
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» Metimazol 2,5 mg/gato BID ____________________________________
» Eficácia de 90%!!! ____________________________________
» Barato ____________________________________
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» Carbimazol 5 mg/gato BID/TID ____________________________________
» Propriltiouracila 10 mg/kg BID/TID ____________________________________
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» X Efeitos colaterais: anorexia, êmese, ____________________________________
letargia. ____________________________________
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» X Terapia ad eternum ____________________________________
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TRATAMENTO ____________________________________
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»Iodo radioativo ____________________________________
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»Radiodoterapia com I131 IV ou VO ____________________________________
» Promove irradiação e destruição de ____________________________________
células hiperplásicas/neoplásicas ____________________________________
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» Alta eficácia, sem efeitos colaterais ____________________________________
» Evita a inconveniência de medicamento ____________________________________
diário ____________________________________
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» X Infraestrutura adequada ____________________________________
(radioisótopos) ____________________________________
» X Internação 7-10 dias após ____________________________________
» X $$$ ____________________________________
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TRATAMENTO ____________________________________
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»Cirúrgico ____________________________________
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»Tireoidectomia ____________________________________
» Terapia definitiva! ____________________________________
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» Parcial/Unilateral x Total/Bilateral ____________________________________
» Intracapsular x Extracapsular ____________________________________
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» X Paciente idoso x Cirugia ____________________________________
» X Hipotireoidismo ____________________________________
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» X Hipoparatireoidismo ____________________________________
» X Síndrome de Horner ____________________________________
» X Recidivas ____________________________________
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TRATAMENTO ____________________________________
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»Lembrar de tratar as alterações ____________________________________
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concomitantes! ____________________________________
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» DRC: fluidoterapia, citrato de potássio, eritropoetina, ____________________________________
etc…
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» Cardiomiopatia hipertrófica: atenolol, furosemida, ____________________________________
etc... ____________________________________
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» Hipertensão arterial sistêmica: anlodipino, ____________________________________
benazepril, etc… ____________________________________
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