1、2021/8/121煩惱有何懼怕，既然躲不掉，就調好心態與它共存。心向陽光，何懼風霜。茫茫人海你我相遇就是緣分，歡迎下載！MIT DIT DIT MITMIT T4 T3 DIT甲狀腺激素的生物學作用（一）對代謝的影響 1、產熱效應 2、對蛋白質、糖和脂肪的影響（二）對生長發育的影響（三）對神經系統的影響DEFINITIONA congenital disorder of thyroid metabolism characterized by a lower than normal end organ effect of thyroid hormone resulting in the sig

2、ns and symptoms of hypothyroidism. Etiology1、甲狀腺不發育或發育不全、甲狀腺不發育或發育不全Thyroid dysgenesis Etiology2、新生兒暫時性甲狀腺功能減低癥TSH-Binding Inhibitory Antibody (TBIAb)Etiology3、 甲狀腺素合成途徑缺陷Defective synthesis of thyroxine(thyroid hormone)Etiology4、促甲狀腺激素缺乏Thyrotropin deficiency (Thyroid-stimulating hormone, TSH)2021/

3、8/12129、 人的價值，在招收誘惑的一瞬間被決定。2022-3-172022-3-17Thursday, March 17, 202210、低頭要有勇氣，抬頭要有低氣。2022-3-172022-3-172022-3-173/17/2022 10:47:07 PM11、人總是珍惜為得到。2022-3-172022-3-172022-3-17Mar-2217-Mar-2212、人亂于心，不寬余請。2022-3-172022-3-172022-3-17Thursday, March 17, 202213、生氣是拿別人做錯的事來懲罰自己。2022-3-172022-3-172022-3-1720

4、22-3-173/17/202214、抱最大的希望，作最大的努力。2022年3月17日星期四2022-3-172022-3-172022-3-1715、一個人炫耀什么，說明他內心缺少什么。2022年3月2022-3-172022-3-172022-3-173/17/202216、業余生活要有意義，不要越軌。2022-3-172022-3-17March 17, 202217、一個人即使已登上頂峰，也仍要自強不息。2022-3-172022-3-172022-3-172022-3-17Etiology5、甲狀腺或靶器官反應性低下Thyroid hormone unresponsivenessEt

5、iology6、碘缺乏Defect of iodide CLINICAL FEATURESCLINICAL FEATURES Neurological manifestationsinfantile hypotonia lack of crying (good baby) psychomotor delay sluggish/disinterested somnolence Respiratory ManifestationsRespiratory Manifestationsapnea choking spells with feeds nasal obstruction noisy res

6、pirations respiratory distress syndrome Cardiovascular ManifestationsCardiovascular Manifestationscardiomegaly murmers slow heart rate Gastrointestinal ManifestationsGastrointestinal Manifestationsconstipation delayed dentation feeding difficulties high birth weight large abdomen macroglossia poor a

7、ppetite prolonged jaundice unbilical hernia Cutaneous ManifestationsCutaneous Manifestationscoarse, brittle, scanty hair cold and mottled skin deep, hoarse voice dry, scaly skin edema of genitals & extremities low hairline myxedema Musculoskeletal ManifestationsMusculoskeletal Manifestationsnorm

8、al body weight but decreased length normal or increased head size broad, short fingers pseudohypertrophy (calf) short limbs short thick neck Endocrine ManifestationsEndocrine Manifestationsgoiter (with error of thyroid metabolismINVESTIGATIONSINVESTIGATIONSScreeningScreeningall neonates are screen a

9、t 48 hours for TSH (and/or T4) from a blood drop placed on filter paper if result is 0.20 mIU/L see patient immediately for history/physical, to draw a serum T4 and TSH, and to start thyroid hormone therapy (see below) SerumSerumelevated TSH and reduced T4 anemia unconjugated hyperbilirubinemia Radi

10、onuclide ScintigraphyRadionuclide Scintigraphyradioactive technetium to detect developmental defects of the thyroid (i.e., dysgenesis, ectopia, etc.) Skeletal X-RaysSkeletal X-Raysfor baseline bone age retardation of osseous development Differential diagnosis佝僂病21-三體癥先天性巨結腸骨骼發育障礙的疾病MANAGEMENTMANAGEM

11、ENTThyroid Replacement start thyroid hormone at 6 ug/kg po qd Maintenance see initially at 3 and 6 months of age then q6m moniter TSH, T4 levels, growth parameters, clinically .PrognosisPrognosisnormal growth, intelligence, and life span if detected within the first few weeks of life short stature,

12、mental retardation, and delayed puberty with delays in detection, progressive ataxia 地方性呆小病的主要病因是A 母親孕期飲食中缺碘B 垂體分泌TSH減少C 甲狀腺發育異常D 甲狀腺激素合成障礙E 母親在妊娠期應用抗甲狀腺藥物甲狀腺組織的散發性 呆小病出現癥狀的最早年齡通常是？A 13個月B 46個月C 78個月D 910個月E 1112個月9、 人的價值，在招收誘惑的一瞬間被決定。22.3.1722.3.17Thursday, March 17, 202210、低頭要有勇氣，抬頭要有低氣。*3/17/2022

13、 10:47:07 PM11、人總是珍惜為得到。22.3.17*Mar-2217-Mar-2212、人亂于心，不寬余請。*Thursday, March 17, 202213、生氣是拿別人做錯的事來懲罰自己。22.3.1722.3.17*March 17, 202214、抱最大的希望，作最大的努力。2022年3月17日星期四*22.3.1715、一個人炫耀什么，說明他內心缺少什么。2022年3月*22.3.17*March 17, 202216、業余生活要有意義，不要越軌。*3/17/202217、一個人即使已登上頂峰，也仍要自強不息。*22.3.17謝謝大家謝謝大家2021/8/12399、

14、 人的價值，在招收誘惑的一瞬間被決定。2022-3-172022-3-17Thursday, March 17, 202210、低頭要有勇氣，抬頭要有低氣。2022-3-172022-3-172022-3-173/17/2022 10:47:07 PM11、人總是珍惜為得到。2022-3-172022-3-172022-3-17Mar-2217-Mar-2212、人亂于心，不寬余請。2022-3-172022-3-172022-3-17Thursday, March 17, 202213、生氣是拿別人做錯的事來懲罰自己。2022-3-172022-3-172022-3-172022-3-173/17/202214、抱最大的希望，作最大的