ASSIGNMENT

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 THYROID DISEASE
History: A 35 year old nurse complained of nervousness, weakness, and palpitations
with exertion for the past 6 months. Recently, she noticed excessive sweating and
wanted to sleep with fewer blankets than her husband. She had maintained a normal
weight of 120 pounds but was eating twice as much as she did 1 year ago. Menstrual
periods have been regular but there was less bleeding.Physical examination: Pulse
was 92/minute and BP was 130/60. She appeared anxious, with a smooth, warm,
and moist skin, a fine tremor, a bounding cardiac apical impulse, a pulmonic flow
murmur, and she couldn't rise from a deep knee bend without aid. Her thyroid
contained 3 nodules, 2 on the right and one on the left with a total gland size of 60
grams (3 times normal size), all nodules being of firm consistency and there was no
lymphadenopathy. Her eyes were not prominent (proptotic) and she had no focal skin
thickening.Laboratory studies: Serum T4=15.6 ug/dl and serum T3=250 ng/dl
(N=80-160).
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  1. What is the level of thyroid function in this patient? Are additional diagnostic tests necessary to define the level of
thyroid function and if so which one(s)? Answer
 2. What are the symptoms that made you consider that diagnosis? Answer

 3. What physical findings supported the diagnosis? Answer

 4. Which lab data supported the diagnosis? AnswerExplain-Hypothalamic-Pituitary-Thyroid axis and

interrelationship.
 5. What are the most likely causes? Answer

 6. What additional aspects of the history and physical examination could provide relevant information to help in the
clinical diagnosis? Answer
 7. What is the most likely cause of this patient's illness? What tests are necessary to confirm its cause? Are
antithyroid antibodies helpful? Answer
 8. What are the treatment options? Answer

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 TITLE LOREM IPSUM DOLOR SIT AMET

 THYROID DISEASE
 History: A 35 year old nurse complained of nervousness, mood swings, and
palpitations with exertion for the past 6 months. Recently, she noticed excessive
sweating. She used oral contraceptives and her menstrual periods were
regular.Physical examination: Pulse was 92/minute and BP was 130/60. She
appeared anxious, with cool, moist skin, a fine tremor, and a bounding cardiac
apical impulse. Her thyroid was not palpable and there was no lymphadenopathy.
Her eyes were not prominent (proptotic) and she had no focal skin
thickening.Laboratory studies: Serum T4=15.6 ug/dl and serum T3=210 ng/dl.

This study source was downloaded by 100000847688923 from CourseHero.com on 05-23-2022 12:16:59 GMT -05:00
  1. What is the level of thyroid function in this patient? Are additional
diagnostic tests necessary to define the level of thyroid function and if so
which one(s)? Answer
 2. What is the most likely cause of this patient's illness? What tests are
necessary to confirm its cause? Are antithyroid antibodies helpful? Answer
 3. What tests are necessary to confirm its cause? Are antithyroid antibodies
helpful? Answer
 4. Explain total serum T4, binding proteins, free T4, T3 and their
significance. Answer
 5. What are the treatment options? Answer

This study source was downloaded by 100000847688923 from CourseHero.com on 05-23-2022 12:16:59 GMT -05:00
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