PartIV-Treatment Options Carrie was silent for a moment as she touched her daugh
ID: 3521954 • 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
6. a) As we can see, Haydens thyroxin levels reached a very high values after three months of life, which tells us there is an active agent transferred to Hayden from Carie, And that Carie has a problem of hyperthyroidism.
Low dose anti thyroid therapy , will work for Carie, but not that effectively, as she must still have HCG in her body which stimulates the thyroid gland.
There will be a deterioration of condition of Carie if she is continued with low dose anti thyroid drugs.
Other interventions should be applied , such as -
b) if Carie is diagnosed with Graves disease, which is an autoimmune disease, she may be prescribed immunosupression, as it will help in stopping the production of antibodies against its own cells.
8. Thyroid transplant is not recommended in hyperthyroid patients, as it is-
9.Autoimmunism, It is the production of antibodies againsts our own organs , the process is called autoimmune reaction.
This can heppen due to-