PATHOPHYSIO

SIGNS/SYMPTOMS PRESENT JUSTIFICATION

Excess thyroid hormone is

☑
Weight loss associated with a high basal
metabolic weight. This means
that your body burns more
energy while it's at rest, so
weight loss is a common
symptom of hyperthyroidism.

Patient’s Body mass index is

17.2 (Underweight)

☑
Rapid or irregular
heartbeat, palpitations
and hypertension
Hyperthyroidism increases
systolic blood pressure by
decreasing systemic vascular
resistance, increasing heart
rate, and raising cardiac output.

Patient’s heart rate is 150 bpm,

(+) for palpitations and her
blood pressure is 160/100
mmHg.

When your thyroid gland is

☑
Nervousness, overactive and produces thyroid
irritability, trouble hormone excessively, your
sleeping (insomnia), body's processes speed up in
anxiety, fatigue the sympathetic nervous system
resulting in anxiety,
 nervousness, insomnia, and
irritability. (Fight or flight
reactions)

Patient experienced fatigue,

general weakness, anxiety and
nervousness.

In hyperthyroidism, the
☑
Shaky hands and beta-adrenergic stimulation is
muscle weakness/pain incriminated as a mechanism
(myopathy) leading to tremor, abnormal
muscle contractility and reaction
of muscle cells due to
excessive thyroid hormones
also lead to muscle
pain/weakness or inflammation.

Patient experienced hand

tremors and fatigue/weakness.

Excessive thyroid hormone

Sweating or trouble ☑
increases metabolic rate
tolerating heat
resulting in an increase in body
heat temperature that will
eventually cause a person to
sweat.

Patient experienced increased

in body temperature and moist
hands, she also mentioned
 problem in tolerating
environmental temperature by
verbalizing “minsan grabe yung
ginaw, minsan grabe din yung
init.”

Thyroid hormones act on the

Frequent bowel ☑
gastrointestinal tract so an
movements / nausea
excess can cause more
and vomiting
frequent bowel movements,
including diarrhea. An
overactive thyroid speeds up
bodily systems, including
digestion. Altered gastric
motility, which can occur from
thyroid hormone excess may
cause hyperperistalsis resulting
in outlet dysfunction leading to
nausea and vomiting.

The patient mentioned frequent

urination with high urine output
as well as nausea and vomiting.

Enlargement of the thyroid can

An enlargement of the ☑
expand the gland well beyond
neck
its typical size and cause a
noticeable bulge in the neck.
This can be caused by single or
multiple nodules (lumps) in the
thyroid or by an autoimmune
 process caused by grave’s
disease or increased production
of thyroid hormones that can
damage the thyroid gland.

Patient has (+) smooth diffusely

enlarged nodules (thyroid gland)

The thyroid produces hormones

Hyperthermia ☑
that are able to influence how
much the blood vessels dilate.
In turn, this affects how much
heat can escape the body.
When the body makes too much
thyroid hormone, body
temperature rises, this is also
caused by increased
metabolism associated with
excessive thyroid hormones.

Patient is hyperthermic with a

temperature reading of 37.9*C.

Hyperthyroidism can affect

Oligomenorrhea or ☑
fertility by: Disrupting the
amenorrhea (Low
menstrual cycle or binding
estrogen levels)
thyroid hormones with sexual
hormones resulting to reduction
of estrogen or testosterone
level.
 Patient stated that her
menstruation became less
active.

Dirt gets trapped in between the

Onycholysis (Plummer ☑
nail and nail bed, giving it a black
nails)
appearance and hence called
dirty nails of hyperthyroidism.
Plummer's nails indicate long
standing thyrotoxicosis,
irrespective of the cause and
help in differentiating Graves'
disease from viral thyroiditis.

Patient is (+) positive with

plummer nails.

Both lid lag and lid retraction are

Eye pain, Lid ☑
attributed in part to the
retraction,
sympathetic hyperactivity of
Exophthalmos, and
hyperthyroidism, which causes
proptosis (bulging of
excess contraction of the Müller
the eye)
muscle. In the case of thyroid
eye disease, the immune system
attacks the muscles and fatty
tissues around and behind the
eye, making them swollen and
sometimes creating a painful
sensation.
 Patient mentioned that she
experienced eye pain, and she is
(+) for exophthalmos or bulging
of the eye.

Flushed skin/face ❎ Hyperthyroidism increases blood

flow in the extremities, which
often causes the face to flush
and the palms to turn red.

It was not mentioned in the case

that the patient has redness in
the skin or flushed skin.

Osteoporosis ❎ An increased risk of developing

osteoporosis is seen in people
with hyperthyroidism, because it
can trigger an imbalance of
bone-eroding activity by the
osteoclasts.

It was not mentioned in the case

that the patient has osteoporosis.

Diarrhea ❎ Thyroid hormones act on the

gastrointestinal tract so an
excess can cause more frequent
bowel movements, including
diarrhea. An overactive thyroid
speeds up bodily systems,
including digestion.
 There is no data saying that the
patient has diarrhea.

Hypovolemia ❎ Patients with hyperthyroidism are

associated with hypovolemia
because of their sweating,
frequent urination, diarrhea,
nausea and vomiting that could
increase the chance of fluid
volume deficit.

It was not mentioned in the case

that the patient has hypovolemia.

Decreased LDL ❎ Thyroid hormone is important as

it increases LDL receptor
(low-density
expression which will lead to
lipoproteins)
reduction of LDL (bad
cholesterol)

Lipid profile test was not done in

the case.