Mary is a 32-year old mother of two who recently sought medical attention. She c
ID: 87190 • Letter: M
Question
Mary is a 32-year old mother of two who recently sought medical attention. She complained of weakness and feeling rundown. She also complained of gaining 20 pounds over the past year even though her appetite was decreased. Further significant issues in her history included repeated bouts of constipation as well as dry, itchy skin. She reported that, on several occasions, her husband had commented that she seemed depressed and at times mentally sluggish. During the physical portion of the examination, her doctor noted a heart rate of 60 beats per minute (on the low side of normal); a sluggish knee-jerk reaction; puffiness about the face; and dry, brittle hair. During the examination, she became chilled and asked the doctor to please hurry so that she could change back from her gown into street clothes, even though the environmental temperature was quite warm. The doctor suspected hypothyroidism (low thyroid hormone levels), but before she could make a firm diagnosis she needed additional information. She ordered some blood work on Mary that included a standard blood chemistry as well as measurement of thyroid hormone levels. The results revealed a high cholesterol level, which is often seen with hypothyroidism, extremely low thyroid hormone levels; and high TSH, a hormone produced by the pituitary that normally stimulates thyroid hormone secretion. These results told Mary's doctor that her problem was in the thyroid gland, and not in the pituitary gland. Further tests revealed that Mary had a form of thyroid disorder known as Hashimoto's thyroiditis, which is an inherited autoimmune disorder in which follicle cells are attacked by the immune system and destroyed. Thankfully, Mary was successfully treated; all of her original signs and symptoms were reversed to normal, and she has a much Improved sense of wellbeing. What would you think is the proper form of treatment for Mary; how long might have to continue it? Are any of the members of Mary's family likely to suffer from the same problem What would have been the indication if Mary's TSH levels had been low? What type of level of hypothyroidism is Mary suffering from, primary, secondary tertiary hyposecretion? ExplainExplanation / Answer
Answer:
Based on the given information, symptoms and details of Mary's condition are:
1) What would you think is the proper form of treatment for Mary; How long she might have to continue?
2) Are there any members of Mary's family likely to suffer from the same problem
3) What would have been the indication if Mary's TSH levels had been low?
4) What type of level of hypothyroidism is Mary suffering from, primary, secondary, tertiary hyposecretion? Explain.