ENDOCRINE MODULE STUDENT’S GUIDE

General Objectives

In this SGD Session, students will be able to:

1. Briefly discuss the thyroid physiology (iodide metabolism, biosynthesis of thyroid hormones,
transport of thyroid hormones and evaluation of thyroid function.
2. Identify the salient points on physical examination findings that pertains to hypothyroidism and
correlate with lab results as given.
3. Discuss and construct the therapeutic plan for the patient.
4. Make a prescription for the patient.

CASE:

Olivia G, a 76-year old female is complaining of fatigue and a thirty-pound weight gain occurring in the
last 2 months even if she has not been eating anything. She has been seeing her family doctor for 20
years and has a history of hypertension controlled with oral HCTZ 50mg per day.

On inquiry, her answers are the following:

1. I am feeling sad and hopeless lately; have difficulty concentrating and have no interest in activities or
sex.
2. I’m tired all day, have no energy, and don’t feel like myself
3. My skin is flaking off because of dryness.
HPI:

2 months PTA, patient complained of fatigue and noticed a weight gain of 30 lbs without eating
anything. Upon further prompting, patient added that she has been feeling/experiencing
sadness, hopelessness, difficulty in concentrating and has no interest in any activities or sex.
Patient has flaking skin due to dryness.

Physical Examination

General Survey: awake, oriented, appears weak and not in respiratory distress

BP 130/70 HR 89 RR 23 T. 36.9

HEENT: anicteric sclerae, pink palpebral conjunctiva, (+) anterior neck mass, no cervical
lymphadenopathy
Skin: dry, (+) erosions, (+) flaking, (+) senile turgor
Chest/ Lung: ECE, CBS
CVS: distinct heart sounds, bradycardic, no murmur
Abdomen: flabby, hypoactive bowel sounds, not tender
GUT: unremarkable
Extremities: cool to touch, strong pulses, (+) tremors
CNS: deep tendon reflexes: +
GCS 15
Lab:

TSH= 20 ( 0.4-5mU/L) T4= 1.0 ( 4.6-12Ug/dL) T3 =40 (80-180ng/dL)

THERAPEUTIC PLAN TEMPLATE

Health Care Pharmaco- Recommendations/ Monitoring Desired End

Needed therapeutic Goal Intervention for Parameters point
Therapy

Sample Prescription

Name:_____________________________________Age/Sex:_________________
Address:_____________________________ _______________________________

Date:___________________

Rx