Irritable

Introduction Because of the stimulating and emotional impulses, people's minds are easily excited.

Cause

The cause of irritability:

The induction of hyperthyroidism is closely related to autoimmune, genetic and environmental factors, among which autoimmune factors are the most important. Unfortunately, the development of thyroid autoimmunity and the development process have not been known so far, so it is difficult to find a preventive method.

Genetic factors are also important, but the genetic background and genetic approach have not been elucidated, so it is difficult to prevent them genetically.

Environmental factors mainly include various factors that induce the onset of hyperthyroidism, such as trauma, mental stimulation, infection, etc. Although the induction of many hyperthyroidism is mainly related to autoimmunity and genetic factors, it is closely related to environmental factors. If you encounter predisposing factors, you will not develop the disease. It can be seen that the onset of some hyperthyroidism patients may be prevented under the condition of avoiding the predisposing factors.

(1) Infection: such as a cold, tonsillitis, pneumonia, etc.

(2) Trauma: such as car accidents, trauma, etc.

(3) Mental stimulation: such as mental stress, anxiety and so on.

(4) Excessive fatigue: such as overwork.

(5) Pregnancy: Hyperthyroidism may be induced or aggravated in early pregnancy.

(6) Excessive iodine intake: such as eating seaweed and other seafood.

(7) Certain drugs: such as amiodarone.

an examination

Related inspection

Free triiodothyronine index cerebrospinal fluid cycloguanosine serum triiodothyronine serum thyroxine

Exciting examination and diagnosis:

Clinically, it is a very common endocrine disease. Refers to a multi-system of the nervous system, circulatory system, digestive system, cardiovascular system, etc. caused by various reasons such as increased thyroid function, excessive secretion of thyroid hormone or increased levels of thyroid hormones (T3, T4) in the blood. A series of high metabolic syndrome and high excitatory and ocular symptoms.

Pain, tachycardia, heat, sweating, appetite, weight loss, weight loss, fatigue, weakness, emotional excitement, impatience, insomnia, insufficiency, eyeballs, trembling, goiter or swelling, female There may be menstrual disorders or even amenorrhea, men may have impotence or breast development. The thyroid enlargement is symmetrical, and some patients have asymmetrical enlargement. The goiter or swollen assembly moves up and down with swallowing, and some hyperthyroidism patients have thyroid nodules.

First, the nervous system: patients are prone to excitement, mental allergy, tongue and second-hand flat, when there is fine tremor, multi-verbal hyperactivity, insomnia tension, lack of concentration, anxiety, suspicion, etc., sometimes hallucinations, Even sub-mania, but there are also whispers, depression, patients with active reflexes, shortened reflection time.

Second, high-metabolism syndrome: patients are afraid of heat and sweat, often have low fever, high fever in crisis, more heart palpitations, stomach sputum, but weight loss, fatigue and weakness.

Third, goiter: more diffuse symmetry enlargement, a few asymmetry, or swelling is obvious. At the same time, thyroid blood flow increases, and vascular murmurs and convulsions and tremors can be heard on the outside of the upper and lower leaves, especially in the upper part of the gland. This sign is of great significance in terms of diagnosis.

Fourth, eye signs: invasive exophthalmos and non-invasive exophthalmos, also known as benign exophthalmos, patients with prominent eyeballs, eyes gaze or look terrified; the former called malignant exophthalmos, can be transformed from benign exophthalmos, Patients with malignant exophthalmos often have fear of light, tearing, diplopia, vision loss, eye swelling, tingling, foreign body sensation, etc. Because the eyeball is highly prominent, the eye can not be closed, the conjunctiva and cornea are exposed, causing congestion and edema. Corneal ulceration, etc., even blindness. Some patients with hyperthyroidism have no ocular symptoms or symptoms.

Fifth, the cardiovascular system: complaints of heart palpitations, shortness of breath, a little activity is obviously intensified. There are often tachycardia (multiple sinus), arrhythmia, cardiac hypertrophy, enlarged and congestive heart failure, as well as severe arrhythmia, heart enlargement, heart failure and other serious manifestations, as well as reports of sudden ventricular fibrillation.

Sixth, the digestive system: appetite hyperactivity, but the weight is significantly reduced, the two are often accompanied by the possibility of this disease or diabetes. Excessive thyroid hormone can stimulate bowel movements and increase the frequency of bowel movements. Sometimes fat dysfunction caused by fat malabsorption thyroid hormone has direct toxic effects on the liver, resulting in hepatomegaly and BSP retention and GPT increase.

Seventh, blood and hematopoietic system: the total number of WBCs around the disease is low, the percentage and absolute value of lymphocytes and mononuclear cells increase, platelet life is also short, sometimes purpura can occur, due to increased consumption, malnutrition and iron utilization Obstacles can cause anemia.

Eight, exercise system: the main performance is weak muscle weakness, a small number of visible hyperthyroid myopathy.

Nine, reproductive system: women's menstruation decreased, the cycle is extended or even amenorrhea. However, some patients can be pregnant and have children. Men are more impotence.

Ten, skin and extremities: a small number of patients are typically symmetrical mucinous edema, but not hypothyroidism, more common in the lower part of the lower leg, sometimes seen in the back and knee, facial upper limbs and head. Dark red skin lesions at the beginning, thick and thick, then flaky or nodular, and finally dendritic, with secondary infection and pigmentation. In a small number of patients, the soft tissue of the fingertips is swollen, the formation of new bone under the periosteum of the metacarpophalangeal, and the separation of the adjacent free edge portion of the finger or toenail and the nail bed are called thick fingertips.

XI. Endocrine system: In addition to affecting gonadal function, adrenal cortical function is often active in the early stage of the disease, but in patients with severe disease (such as crisis), its function is relatively reduced, or even incomplete; pituitary secretion of ACTH Increased, plasma cortisol concentration is normal, but its clearance rate is accelerated, indicating that its transport and utilization increase. Eye changes caused by hyperthyroidism.

Differential diagnosis

Symptoms that are irritating and confusing:

Easily stimulating: Psychiatric symptoms of patients with Cushing's syndrome, such as prone to excitement, depression, and even schizophrenia. Cushing's syndrome is a syndrome caused by excessive secretion of cortisol from the adrenal cortex. Psychiatric symptoms include common susceptibility to depression, depression, etc., and may even have schizophrenia.

Irritability: A state of overreaction, including trouble, impatience, or anger. It can be seen in fatigue, chronic pain, or as a clinical feature of emotional abnormalities, occurring in senile, brain trauma, epilepsy, and affective disorder. This is a severe but persistently low emotional disorder. When a patient experiences a stimulating or unpleasant situation, even if it is extremely mild, it is easy to produce some severe emotional reactions. The patient is extremely angry, excited, angry, and even furious, arguing with others. Common in rickets, neurasthenia, manic state, somatic or brain organic psychosis.

Emotional Outbreak: This is a sudden emotional disorder that suddenly occurs under the influence of psychological factors. The patient can show moodiness, yelling, wrecking, smashing, screaming, crying, or screaming, dancing, laughing, often accompanied by spoiled, artificial, childish and acting colors, sometimes rolling on the ground, extremely violent, the whole The phenomenon is very different, and the change is great, but the perception of the surrounding things is unobstructed and the consciousness is clear.

Mania: frenzied, disturbed by hands and feet, is a kind of syndrome of sorrow. The main clinical symptoms are high mood, thinking and emotional excitement. Significant and lasting changes in mood - high mentality as the basic clinical manifestations, accompanied by corresponding thinking and behavioral changes, a tendency to recurrent, complete relief in the intermittent period. Those with milder symptoms can not reach the level of mental illness. The onset of the disease is a manic phase. The meaning and diagnostic criteria are: the patient's state of mind is high, and it is not commensurate with the situation in which it is located. It can be elated, irritating, agitated, and even cause disturbance of consciousness. In severe cases, psychotic symptoms such as delusions and hallucinations that are coordinated or uncoordinated with the mood may occur.

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