PartIV-Treatment Options Carrie was silent for a moment as she touched her daugh
ID: 3521953 • Letter: P
Question
PartIV-Treatment Options Carrie was silent for a moment as she touched her daughters hair. "What about Hayden? she asked. "Does our daughter have this too Dr. O'Dell pulled out another sheet of lab results. "Hayden's thyroxin levels were at the high end of normal during her newborn blood screen. Did anyone suggest a follow-up blood test? No, answered Robert. "They said everything was fine. "I'm afraid Hayden also has a problem, but one I hope is relatively casy to solve. Heres the data Hayden (newbom) 15.0 ug/dL Hayden 3 mos) 222 ug/dl 03 mlUN Thyroid hormone (thyroxin) 6-15 ugldl 03-3.04 mIUL Thyroid stimulating-hormone (TSHONot performed Questions 1. Which values for Hayden (of those given) are abnormal or borderline 2. Given Carries diagnosis, what is the most likely sourcelcause of Haydens problem? 3. How did the "active agent" enter Hayden? Give two possible routes. 4. If Carrie had continued to breast feed, how would that have affected Haydens problem 5. For Hayden, Dr. O'Dell suggests three months of a low dose anti-thyroid medication (such as methimazole that will reduce her thyroxin production. Regular blood tests to monitor both thyroxin and TSH levels will be continued during this time a. Why is short-term therapy (of several months duration) likely to work b. Hayden's treatments would end about 6 months after her birth. Why is that number significane c. Will long-term therapy (years or lifetime) be needed? Why or why nor? d. Graves disease may have a heritable component. What furure testing would you suggest for Hayden 6. a. Will this same therapy work for Carrie? What will happen as treatment progresses b. What about general immunosupression as a treatment? Name a potential consequence 7. Dr. O'Dell explains that Carrie may need to have treatments with a shor-lived radioactive isotope of iodine that will accumulate in her thyroid gland along with the normal iodine concentrating there. a. What will these treatments accomplish? b. What will happen to antibody levels as a result? List the players and the general sequence of events c. Why would thyroid hormone pills be prescribed after treatment is completed d. Surgical removal of the thyroid gland (thyroidectomy) is rarely used to treat this problem. What would it accomplish here? Name a potential danger of this surgery (think anatomically). 8. Could Carries problem be solved by a thyroid transplant from a matching donor? Explain 9. Autoimmunities are relatively uncommon. What usually happens to autoimmune antibody-producing clones during development? Hot and Bothered" by Karin A. Grimne Page sExplanation / Answer
7 A) Short lived radioactive isotopes are therapeutically in destroying overactive thyroid cells radioactive isotopes of iodine release gamma and beta radiation which are very active in killing overactive cells which are seen in Hayden case the Thyroxin cells are range of 22.2 ?/ml whereas normal is 6-15 ?/ml. The iodine is effective in destroying cancer cell without destroying the other cells in body. As radioactive isotopes will be seen in body for longer time hyperactive cells can be controlled easily.
B) If the treatment with radioactive iodine isotope is successful low levels of thyroglobulin antibodies can be seen in the body which can be also used as a marker for evaluating the Hyperthyroidism disease in patient if the antibodies rises after it means there is chance of reoccurrence of disease and antibodies may attack own body cells causing autoimmune disease if the antibodies level fall it can concluded that the treatment with radioactive iodine isotope is successful and all cancer cells are destroyed.
C) Thyroid hormone pills are prescribed after treatment to compensate the lost thyroid hormones during the treatment. These tablets are to be taken higher than required level which will prevent the body producing another hormone called thyroid stimulating hormone which may give rise to cancer cells.
D) Surgery in removing thyroid glands is rarely used it is used generally when the gland is big or tit is obstructing the air and food passage but most cases it is avoided. The surgery involves removal of cancer form thyroid gland. But it may many risk factors voices can change or totally lost as the nerves controlling the voice are closer to thyroid glands it may also cause damage to parathyroid glands next present to thyroid glands causing condition called hypoparathyroidism in which body cannot regulate calcium and phosphorous levels in blood causing muscles problems seizures and heart problems.