Askep hiperparatiroid

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1 !%$ %/,8050795075,7,974/8202,3,0203 %/,8050795075,7,974/8202,3,020320/8,/,,,,3 20/8,/,,,,3:9,2,:39: :9,2,:39:  507,,9,35075,7,974/82080:3/07!0302  507,,9,35075,7,974/82080:3/07!0302-:,3/03,3.,.974 -:,3/03,3.,.974/,3,8:2 /,3,8:2 /,5,9203.0,,9,:20232,875075,7,974/82080:3/0 /,5,9203.0,,9,:202 32,875075,7,974/82080:3/0743974,/,7 743974,/,7 .,7,31481,9/03,3/09703/,1481,9: .,7,31481,9/03,3/09703/,1481,9:,50393!,803,3203,,2 ,50393!,803,3203,,2570/,88 570/,88 703,1,:70-,8,3,203,,25033,9,3,/,7 703,1,:70-,8,3,203,,25033,9,3,/,7472435,7,974/ 472435,7,974/!030,3,3 !030,3,3 80708472435,7,974//03,34/4 80708472435,7,974//03,34/480.,.9742:33/,5, 80.,.9742:33/,5,9203.0, 9203.0, 5075,8,003,75,7,974//,35075,7,9 5075,8,003,75,7,974//,35075,7,974/82080:3/07!,803 74/82080:3/07!,803,3 ,3 203,,2/,88/0503/039.743.1,:70 203,,2/,88/0503/039.743.1,:70 202-:9:,3.,.9748:50203 202-:9:,3.,.9748:50203 ,8:21481,9-0-,8,:23:2/,3 ,8:21481,9-0-,8,:23:2/,3.3,.,.0980385,7:39: .3,.,.0980385,7:39:2020,7,0;0 2020,7,0;0 .,7,3,8:2/,31481,9,703,5,803 .,7,3,8:2/,31481,9,703,5,803/,8870,917039,3907,/,54 /,8870,917039,3907,/,547243 7243  5,7,974/!,803,3203,,23:9:,3,  5,7,974/!,803,3 203,,23:9:,3,9,:5,9,9:,357:79:8 9,:5,9,9:,357:79:8/,3 /,3 .,.5,8507:507,,9,3/03,3,,34507,80 .,.5,8507:507,,9,3/03,3,,34507,80,,,35,/,907,520/ ,,,35,/,907,520/8:39: 8:39: 203439745075,7,974/820:,2033/ 203439745075,7,974/820:,2033/,8,3:39:203 ,8,3:39:203,,34507,8 ,,34507,8 &2:23,,0;0472435,7,974/0- &2:23,,0;0472435,7,974/0-93/,752 93/,7528090, 8090,  5034708,3,/,7,8:2/,3  5034708,3,/,7,8:2/,30;0148147/,390-: 0;0148147/,390-:9,/,3,0,3,35,/,9:,3 9,/,3,0,3,35,/,9:,3   503,3,9,3003,75,7,974/80-,3  503,3,9,3003,75,7,974/80-,3,/50792-,3,3 ,/50792-,3,3

 !#!#%#%#$# ,$ , $ 5075,7,974/820907807,/,,507025075,7,974/820907807,/,,50702-,3,3/,75075,7,974/ ,3,3/,75075,7,974/82080:3/07 82080:3/07 ,390,//079,,2,!03,95075,7,974/82090780 ,390,//079,,2, !03,95075,7,974/8209078073/9,3/,/03,3 73/9,3/,/03,3  50702-,3,3507807084  50702-,3,350780708472435,7,974/,703,507,802 72435,7,974/,703,507,802, ,  - % !030-,-3,2,8-0:2/09,:!07:!030-,-3,2,8-0:2/09,:!07:-,,32:33907,/5,/,99 ,,32:33907,/5,/,99503,9:7 503,9:7 20,3820,8:25,/,0;0507,802 .!%$ . !%$ 5075,7,974/8209078075,3:2:2/,2,95,/ 5075,7,974/8209078075,3:2:2/,2,95,/,5,803503/079, ,5,803503/079, 5075,7,974/82080:3/07,3 5075,7,974/82080 :3/07,37438/,3,390,203 7438/,3,390,203,,3.,343, ,,3.,343, 003,750797450/5,7,974/,,02-,203 003,750797450/5,7,974/,,02-,203,/3472,/,3907:8 ,/3472,/,3907:8 2030:,7,3472435,7,974/-070-208 2030:,7,3472435,7,974/-070-2085:3,/,7.,7,3,8:2 5:3,/,7.,7,3,8:22,8/,,2 2,8/,,2 0;03472,,9,:-,,3-07,/,/,9,83472,!,/,,8: 0;03472,,9,:-,,3 -07,/,/,9,83472,!,/,,8:83003,750 83003,75079745/ 79745/

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O

470870/7,8.05,950731:80

O

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O

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O

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4

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

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%::,3 %::,3  $09,, $09,,  /,: /,:,3 ,3 93/, 93/,,3 ,3 050 0507, 7,,9,3 ,9,3 80,2 80,2, , 574808 574808 0507 0507,,9 ,,9,3 ,3 /,7,5 /,7,5,3 ,3 307/,5,9-07:7,3,3  4397407 7907,,8 

,25: ,25: 203 20343 43974 974  307 307   9,: 9,: 5030 5030-,-,- 307 307  2,25: ,25: 203 203: :3, 3,,3 ,3 903 903  343 1,72,44:39:203:7,3307203.,7-,39:,3



0,547,3-,,307-07:7,3 0,547,3-,,307-07:7,3/03,32,3,0203307 /03,32,3,0203307 



,25:20303,3078,,390389,8 ,25:20303,3078,,390389,8170:038/,39,3/, 170:038/,39,3/,307 307



03,9,,37,8,3,2,38090,307-07:7,3

 !,32,3,02039 

,80.,7,4257003819039,3307205:94,8,7,90789/,343809/:7,8 170:038:,9,8390389,8-07,93,30 170:038:,9,8390389,8-07,93,307/,31,.9471,.947570/85 7/,31,.9471,.947570/85488 488



-80 -807; 7;,8 ,8 8, 8,7,9 7,9 8 8,7 ,7,9 ,9 343 343 ;07;07-, ,

/,7 ,7 09/ 09/, ,3 3,2 ,2,3 ,3,3 ,3  :8 :8: :83 83, /,,2 ,,2

09/,2,25:,3:39:-0742:3,880.,7,01091 

:3,,342:3,8907,50:9,,75,803 :3,,342:3,8907,50:9,,75,803/,5,9203085708,330 /,5,9203085708,3307 7



3:7 3:7,3 ,3 503 503:3, :3,,3 ,3 903 903 343 1,72,4 1,72,44 4  0 0 70,8 70,8,8 ,8  :/0/ :/0/ 2,0 2,07 7  907,5 907,5 2:8/897,8,5,85,3,8/332,8,80/



07,3,3009:39:203:7,3307

0907,3,3$,,  %/,20,:,3  ,7,320,:,3  ,/,320,:,3  $07320,:,3  $0,:20,:,3

39407,38,9; 39407,38,9;9,8-07:-:3 9,8-07:-:3,3/03,3 ,3/03,3002,,34949 002,,34949

%::,3 %::,3  $090, $090, /,: /,:,3 ,3 93/, 93/,,3 ,3 050 0507, 7,,9,3 ,9,3 80,2 80,2, , 574808 574808 0507 0507,,9 ,,9,3 ,3 /,7,5 /,7,5,3 ,3  5,803/,5,920,:,3,9;9,8/03,33472,

 .9;9%407,3.0 7907,,8  $,9:7,84803/,,2-,9,83472,  %/,,2-,9,83472,8,,9-07,9;9,8  #,9,7,9,70857,8/,,2-,9,83472,8,,9-07,9;9,8  0,547,3,/,3,0:,9,34949  ,25:20203:0-:9:,380,7,7 0907,3,3$,,  $0,:203:3:,3  $073203:3:,3  ,/,3203:3:,3  ,7,3203:3:,3  %/,203:3:,3  .9;9%07,5 

4,-4 4,-47,8 7,8 ,3 /03,3 /03,3 903,, 903,, 70,- 70,-9, 9,8 8 20/ 20/ /,,2 20703. 20703.,3, ,3,,3 ,3 5747,2 5747,2 907,5 907,5 ,3905,9



,39:03:39:203/0391,8,9;9,8,32,25:/,:,3



,39:03:39:203/0391,8,9;9,8,3/8:,



,39:03:39:202-:,9,/,,9,3/,9::,3



,39:5,803:39:20302-,3,3249;,8/7/,7503:,9,3 7/,7503:,9,3 ,39:5,803:39:20302-,3,3249;,8/



4394770854318024884.,/,38579:,

09/,802-,3 09/,802-,3,3.,7,3-07: ,3.,7,3-07:-:3,3/03,3 -:3,3/03,32:39, 2:39,

%::,3 %::,3  $090, $090, /,: /,:,3 ,3 93/, 93/,,3 ,3 050 0507, 7,,9,3 ,9,3 80,2 80,2, , 574808 574808 0507 0507,,9 ,,9,3 ,3 /,7,5 /,7,5,3 ,3 0-:9:,3.,7,3/,5,9907503:  :/,,3.0 7907,,8  025079,,3,3:734:95:9808:,/03,3:8,/,3 :7303472,%3472,  %3,/$::/,,2-,9,83472,  %/, %/, ,/, 9,3/,9 9,3/,9,3/ ,3/, , /0/7 /0/7,8 ,8  0,89 0,8989 89,8 ,8 9:747 9:747 :9 :9 -, -, 202-7,3 202-7,3 2:48, :48, 02-,02-,-  9/,,/,7,8,,:8,3-070-,3

0907,3,3$,,  $0,:203:3:,3  $073203:3:,3  ,/,3203:3:,3  ,7,3203:3:,3  %/,5073,203:3:,3

 :/,3,02039  !079,,3,3.,9,9,339,0/,34:95:9,3,:7,9  43947%%'  439472,8:,32,,3,3.,7,3/,3 439472,8:,32,,3,3.,7,3/,39:339,0,47,7,3 9:339,0,47,7,3   4,-47,8502-07,3.,7,32,,3,3  4394789,9:83:978 43947 43947 89,9:8 /7,8 /7,8  002-,-,3 002-,-,3 202-7,30 202-7,30  3,/ ,/0:,9 ,/0:,9 90,3,3 /,7, /,7, 479489,9 479489,9   ,/507:,3

 '  0 09/ 9/, ,802 802-,3 -,3,3 ,3 3:97 3:978 8 :7,3 :7,3  /,7 /,7 00-:9: :9:,3 ,3 9:-: 9:-: -07 -07: :-:3 -:3,3 ,3 /03,3,34708,

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