Past history Ms. C is a 30 year old woman. She reports a weight loss of 25 pound
ID: 3476654 • Letter: P
Question
Past history
Ms. C is a 30 year old woman. She reports a weight loss of 25 pounds in the last 2 months, despite an increased appetite. She has noticed that her heart seems to race and pound, even when she is at rest. She has been very irritable and has suffered from bouts of diarrhea. She states that she always feels too warm, even when others say the room is cold. The collars on her clothing feel too tight and she has begun to experience blurred vision. Though she has always had a history of regular menses, she has not had a period in 2 months.
Physical examination:
Ms. C is a thin, pale, anxious woman who moves restlessly around the room. Her eyes have a bulging, staring appearance and a mass can be seen on the anterior of her neck. Her skin is smooth, warm and moist. She is sweating profusely, though the room temperature is 66o F. Her hair is very fine and soft. She weighs 102 lbs on admission, a loss of 25 pounds from her normal weight. Her vital signs are as follows:
Oral temperature: 99o
FResting heart rate: 120
Blood pressure: 110/50Laboratory tests show that her T3 levels are high, her T4 levels are low, and her TSH levels are normal.
questions:
What is the most likely diagnosis? (1 pt)
a.Hashimoto’s thyrotoxicosis
b.Hypertension
c.Anorexia Nervosa
d.Grave’s disease
2.What is the most likely cause? (1 pt)
a.Malignant tumor of the thyroid
b.Anterior pituitary tumor
c.Lack of iodine in diet
d.Autoimmune response
3.What is a goiter?
Why does Ms. C have one? (2 pts)
4. List three treatment options for Ms. C.
What are the advantages and disadvantages to each? (3 pts)
Explanation / Answer
1) Grave's disease since all the signs are matching with grave's disease symptoms.
2) Lack of iodine in diet.
3) Goiter is swelling of neck due to deficiency of iodine in diet resulting into enlargement of thyroid glands.
Ms. C had Thyroid hormones were less so she had that problem.
4) Treatment would be provide thyroid hormone pills to increase it, Synthetic preparations of T4 (l-thyroxine) are preferred, but preparations of T3 (liothyronine) and combinations of both may be tried and increase iodine content in diet.