s i s t e m e n - dr hertati

7/25/2019 s i s t e m e n - Dr Hertati

1/95


2/95


3/95

EMOSI

Stres Hipotalamus Obat

R.F

Kel.Pituitaria

Tropic Factor

Kel.Sasaran

Sel.Sasaran


4/95


5/95


6/95


7/95


8/95

FUNGSI :

REGU!SI

" HIPOT!!MUS

" KE.PITUIT!RI!

" ORG!N EN#OKRIN


9/95

H I P O T ! ! M U S

$ PUS!T : REGU!SI

% HORMON :

& T.R.H& '.R.H& P.I.F

& G.H.R.F& GON!#O TROPHIN ( R F


10/95

$ G!NGGU!N :

) FUNGSI :* HIPO

* HIPER

) M!SS :

* FUNGSION!* NON FUNGSION!


11/95

KEEN+!R PITUIT!RI!

+enis Sel , HormonSomatotrop- /0 G.H

Mammotrop- 10 2 30 P.R.4actotrop-5'orticotrop- 1/ 2 30 !.'.T.H

Gona6otrop- 10 .H 7 F.S.HT-8rotrop- / T.S.H


12/95

K E ! I N ! N :

1. HIPO PITUIT!RISME

3 . HIPER PITUIT!RISME


13/95

9 HIPER PITUIT!RISME

!#ENOM! ;;;

'!R'INOM!

HIPERP!SI!

TUMOR NON EN#OKRIN

ESI HIPOT!!MUS


14/95

9 Pena Melebar

= Erosi Procesus Klinoi6 !nterior

= Pene>anan Kiasma ? N.Opti>us


15/95

9+ENIS !#ENOM! HIPOFISE

!. !#ENOM! SOM!TOTROPH

@ GIG!NTISME@ !KROMEG!I

A. PRO!KTINOM! ;;;;

@ !MENORHE! 2 G!!'TORHE! SBN#R


16/95


17/95

'.!#ENOM! 'ORTI'OTROPH

@ PRIMER : 'us-in< C s 6isease@ SEKUN#ER : Post !6renal ectomi (((((((((; D Nelsons S8n6rome

#.!#ENOM! GON!#OTROPH


18/95

9H I P O P I T U I T ! R I S M E

1. #ESTRUKSI 0 2 0 ,

3. SEKUN#ER !KIA!T ESIHIPOT!!MUS


19/95

ETIOOGI :

" !#ENOM! NON FUNGSION!" NE'ROSIS PITUIT!RI!

4 DS-ee-ans S8n6rome 5

" EMPTB SE! SBN#ROME

+!R!NG :Sarcoi6osis

InJe>si 4 Menin


20/95

#eJisiensi Hormon Aerurutan :

G.H F.S.H 7 .H

T.S.H !.'.T.H P.R.

+!R!NG : #EFISIENSI MONO HORMON!


21/95

$ POST PITUIT!RB SBN#ROME

L S!NG!T +!R!NG

L ETIOOGI : Tumor Hipotalami> #estru>si obus Posterior Metastasis

? inJe>si I6iopati>


22/95

L !KIA!T :

#EFISIENSI !.#.H

((((((((; #I!AETES INSIPI#US

!.#.H meninat


23/95

K E E N + ! R T B R O I #

G!NGGU!N :

1.PEMAES!R!N TBROI# 4 GOITER5

3.TIROTOKSIKOSIS

.HIPOTIROI#


24/95


25/95

TIROTOKSIKOSIS

Kea6aan Hipermetaboli> 6i in6u>si>arena arintiJ berlebi- Q Pro6u>si Aerlebi- Pelepasan Aerlebi-

HIPER TBROI# Han8a Pro6u>sin8a Aerlebi-


26/95

H I P O T B R O I # I S M E

1. ' R E T I N I S M E= NEUROOGIK

= MIKSOM!TOUS

3 . M I E # E M !


27/95

P E N B E A ! A Q

1. +!RING!N P!RENKHIM Gan


28/95

3.G!NGGU!N SINTESIS :

Primer 4 Aloc>in< 2 !b 5 #eJe> Geneti>

#eJisiensi Bo6ium Obat Tiroi6itis Has-imoto

.G!NGGU!N SUPR! TIROI# : T.S.H 4 Pituitaria 5 T.R.H 4 Hipotalamus 5


29/95

H I P E R T I R O I # I S M E

ETIOOGI : Hiperplasia Primer #iJus ;;;

Toic Multi No6ular Goiter

Toic !6enoma !6enoma HipoJise ((((; F.S.H


30/95


31/95

$.P!TOGENESIS

!NTI RESEPTOR TSH= TSITiroi6 Stimulatin< Imuno Globulin

= TGI Tiroi6 GroZt- Stimulatin< Globulin

MIKROA! 4 BERSENI! 5= !FINIT!S TINGGI TERH!#!P TSH


32/95

$ .M O R F O O G I :

[ EPITE ;;;[ 'OOI#

[ INFITR!SI IMFOSIT[ TRI!S : OPTH!MO P!THB

#ERM!TO P!THB '!R#IO MIO P!THB


33/95

G O I T E R 4 S T R U M ! 5 :

#IFFUS 4 SIMPE 5 GOITER

MUTI NO#U!R GOITER


34/95

#IFFUS 4 SIMPE 5 GOITER

9 EN#EMIK ; SPOR!#IS

9 ETIOOGI : ( 6eJisiensi Bo6ium ( oloi6


35/95

9 KINIS :

\ Geala HipoT8roi6

\ Eut8roi6 setela- pembesaran T8roi6

\ Aeruba- mena6i Goiter Multi No6ula


36/95

MUTI NO#U!R GOITER4 STRUM! !#ENOM!TOS! 5 TOI'

NON TOI'

EN#EMIS ;SPOR!#IS

MEK!NISME :

Respon Tirosit ter-a6ap TSH berbe6a ariasi Titer TSH


37/95

M O R F O O G I :

Tirome


38/95

TBROI#ITIS

9 InJe>si -ebat >elenar ole- le>osit ?Jibrosis

9 AENTUKNB! :

)InJe>si : ( Tiroi6itis !>ut SupuratiJ( T A ')Sarcoi6osis)Rie6els Fibrosis Tiroi6itis

)Has-imotos Tiroi6itis)#e^uer]ains Tiroi6itis)'-ronic 4 Silent 5 Tiroi6itis


39/95

) H!SHIMOTO C S )

!uto imun (((((; OrPerempuan : la>i( la>i Y 30 : 1Usia pertensi irus


40/95

$.M O R F O O G I :

* Membesar simetris 2 asimetris berlobus* Konsistensi seperti >aret* Fibrosis menroJasi>osis 4 Has-itoicosis 5

* Eutiroi6* Hipotiroi6

$ RESIKO MENINGK!T :* ` 'E BMPHOM!


42/95

SUA !'UTE 4 #EUER!IN5Tis

Rasa sa>it ? bena>

Perempuan : la>i 2 la>i Y 3 : 1

Usia pertensi ]irus 4 5

Proses !uto imun


43/95

$ MORFOOGI

) TBROI# ;;; 3 2 NORM!

) ! SIMETRIS

) S!R!NG NEKROSIS ? FIAROSIS


44/95

$ MIKROSKOPIK :

d NEKROSIS ? KERUS!K!N FOIKEd R!#!NG GR!NUOM!TOS!d FIAROSIS

$ KINIS :* TIROTOKSIKOSIS 4 SEAENT!R 5* SEMAUH SEN#IRI* HIPOTIROI# 4 +!R!NG 5


45/95

' H R O N I ' 4 SIENT 5TIROI#ITIS

IMPHO'BTI' TBROI#ITISP!INEES TBROI#ITIS

PEREMPU!N : !KI 2 !KI Y 3 : 1TBROI# NORM! 7 SE#IKIT ;;;MIKROSK : INFITR!SI IMPOSIT

SEMAUH SEN#IRI4 5 !RI!N H!SHIMOTO 7 GR!E


46/95

T U M O R T B R O I #

+IN!K : " !#ENOM! : Soliter ? Aer>apsul "

!6enoma Foli>uler : Mi>ro ? Ma>ro "

'olloi6 !6enoma " !6enoma Simple " Fetal !6enoma

" Embr8onal 4 Trabe>ular 5 !6enoma "Hurt-les cell !6enoma4 Oncoc8toma 5


47/95

9 #IFFERENSI! #I!GNOS! :

) !#ENOM!

) MUTI NO#U!R GOITER 7NO#U INOUSI

) K!RSINOM! FOIKUER


48/95

9 PEMERIKS!!N :

) USG) SUPRESSI TSH) R!#IO NU'EI#E S'!N) FN! AIOPSI

9 #I!GNOS! P!STI :

) AIOPSI EKSISION!


49/95

$ . G!N!S :

;;; : O''UT '!R'INOM!

1 'M


50/95

K!SIFIK!SI :

1.P!PIER '!R'INOM! TIROI# 7 PT'f0 2 g0 ,

3.FOIKUER '!R'INOM! TIROI# 7FT'

30 2 3/ ,.ME##U!R '!R'INOM! TIROI#7MT'/ 2 10 ,

X.!N!P!STIK '!R'INOM!

4 UN#IFFERENSI!SI 5 (((((((; 10 ,/. EPI#ERMOI# '!R'INOM! ((((((((; 1 ,f. ain 2 lain (((((((((; 1 ,


51/95

P ! R ! T I R O I #

HIPER P!R!TIROI# 4 H P T 5

d PRIMER

d SEKUN#ER

d TERTIER 4 5


52/95

HIPO P!R!TIROI# :

9Etioloalsemia

* HPT primer 4 f0 , 5* En6o>rinopatia : ( Hiper Tiroi6isme ( Feo>romoc8toma

( ipoma* Into>si>asi itamin #


53/95

* Granuloma : ( Sarcoi6osis ( TA' ( Histoplasmosis

* 8mp-oma* Obat : ( T-8ahi6e

( it-ium

( Estroali Mil> S8n6rome ( Into>si>asi itamin ! 7 #


54/95

* Immobilisasi ama

* !cut Renal Failure

* '-ronic Renal Failure


55/95

9 !>ibat Hiper Kalsemia : OSTEO M!!SI!

OSTEO PORESIS

OSTEITIS FIAROS! 'BSTI'!

FR!KTUR MIKRO

NEPHRO '!'INOSIS

NEPHRO ITHI!SIS

K!SIFIK!SI MET!ST!TIK

9 HIPER P!R!TIROI# PRIMER


56/95

9 HIPER P!R!TIROI# PRIMER4 H P T 5

ETIOOGI : !#ENOM!

HIPERP!SI! PRIMER

K!RSINOM!

MEN 1 7 MEN II


57/95

& Patoalsemia

Mobilisasi 'alsium

Reabsorbsi Tubulus

!bsorbsi Intestin

E>s>resi FosJat ((((; Hipo FosJatemia


58/95

HIPO P!R! TIROI#ISME

P T H j 7 AIOOGIK TI#!K EFEKTIF

((((((((((; G!NGGU!N :

9 NEURO MUSKUUS

9 G!NGGU!N MENT!


59/95


k ETIOOGI : OPER!SI TIROI#

P!R! TIROI#EKTOMI R!#I!SI #IGEORGES SBN#ROME

I#IOP!TIK


60/95


k !KIA!T HIPOK!SEMI! :

K!SIFIK!SI INTR! KR!NI!

K!T!R!K

G!NGGU!N #ENTIS


61/95

! # R E N !

K O R T E K S

M E # # U !


62/95

! # R E N !

. K O R T E K S ! # R E N !

GUKO'ORTIOI# 4 KORTISO 5

MINER!O KORTIKOI#4 !#O STERON 5

!N#ROGEN !#REN!


63/95

! # R E N !

. H I P E R F U N G S I ! # R E N ! :

( HIPER KORTIKOISME 4 'USHING 5

( HIPER !#OSTERONISME

( !#REN! IRIISME


64/95

! # R E N !

. H I P O F U N G S I ! # R E N ! :

( Primar8 !6reno 'ortical InsulJisienc8 !cut K-ronis 4 !66isons 5

( Secun6ar8 !6reno 'ortical InsulJisienc8


65/95

' U S H I N G CS S B N # R O M E

. I ! T R O G E N I K . E N # O G E N :

( Pituitar8 'us-in


66/95

' U S H I N GS S B N # R O M E

. P ! T O O G I :

'ROOKES HB!INE #EGENER!TION


67/95

' U S H I N GS S B N # R O M E

. K I N I S :(Obesitas (Moon Face

(AuJJalo Hump (Hipertensi(Hirsustisme (Striae(Gosis(Poli Uri _ Poli #ipsi 4 # M 5


68/95

HIPER !#O STERONISME

P R I M E RS E K U N # E R

! # O S T E R O N :( Se>resi Kalium ( Retensi Natrium

( Hipo Kalemia ( Hiper Natremia( Hipertensi


69/95


70/95

!#RENO GENIT! SBN#ROME

k.INAORN ERROR OF MET!AOISME

k.RESESIF !UTOSOM

k. (((l((((((((((; 'ORTISO

!N#ROGEN


71/95

!#RENO GENIT! SBN#ROME

k. #EFEK ENIM :

31 2 H86ro8lase 4 31 2 H# 5 ;;;

11 2 ` H86roilase

2 ` H86roi Steroi6 #e-i6ro


72/95

!#RENO GENIT!I! SBN#ROME

= #eJisiensi 31 2 H # ( Salt osin< !.G Sin6rom (((; >lasi> ( irilihin< Sin6rome Simple

( Partial 2 31 H86roilase

k.KINIS P!#! NEON!TUS : : Mas>ulinisasi

q : PUAERT!S PRE'OK

HIPOFUNGSI


73/95

HIPOFUNGSIKORTEKS !#REN!

9 D !##ISONS #ISE!SE D

d . M!NIFEST!SI : #ESTRUKSI 0,

d . SUA KINIS : KEAUTUH!N STEROI#

((((((((((((((((; M ! N I F E S T

HIPOFUNGSI


74/95

HIPOFUNGSIKORTEKS !#REN!

9 D !##ISONS #ISE!SE D L . ETIOOGI :

*.!UTO IMMUNE !#REN!ITIS 4 I6iopat-8 !6renal !trop-8 5 ((((((((((((((; /0 2 f0 ,*.T A ' / 2 0 ,*. MET!ST!SIS / 2 10 ,*.+!MUR

*.S!R'OI#OSIS*.!MIOI#OSIS*.HEMO'HROM!TIS


75/95

!'UTE !#REN! INSUFISIENSI

1.(((((((((((((((; STEROI# TIA! 2 TIA!

3.Stress pa6a pen6erita !66isons

.Per6ara-an uas !6renal

4 Water House Fri6eric-sen 5


76/95

!'UTE !#REN! INSUFISIENSI

k.KINIS :=. emas=. Hiperpre>sia (((((((; Hipotermia=. 'oma=. 'ollaps as>uler

k.NEOP!SM! KORTEKS !#REN! :=.!6enoma 4 cm 5=.Karsinoma


77/95

ME##U! !#REN!

9PHEO'HROMO'BTOM! k.'atec-olamine (((((; Hipertensi (((; Fatal

.0, Spora6is_ Unilateral

.10, Ailateral.10, Ganas.10, Familial_ Multipel.Usia #e>a6e 2 X

.!sal :sel para


78/95

ME##U! !#REN!

9 NEURO A!STOM! D

k. / T!HUN

k. !S! : NEUR! 'REST

#apat 6itemu>an pa6aSusunan S8araJ Simpatis


79/95

T B M U S

H I P E R P ! S I !d.KRITERI! :

( Folli>el 8mJoi6 pa6a Me66ula

d.#ITEMUK!N P!#! :1.M8astenia Gra]is3.Sistemi> upus Eritematosus.R-emati> !rt-ritis

T B M U S


80/95

T B M U S

THBMOM! :d.AENIGN! 4 0 , 5d.M!IGN! :

( Epitelial Pre #ominance( 8mp-oi6 Pre #ominance( Mie6 8mp-o Epitelial

K!RSINOM! TBMUS


81/95


82/95


83/95


84/95


85/95


86/95


87/95


88/95


89/95


90/95


91/95


92/95


93/95


94/95


95/95

s i s t e m e n - dr hertati

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