Carrie was silent for a moment as she touched her daughter\'s hair. \"What about
ID: 96096 • Letter: C
Question
Carrie was silent for a moment as she touched her daughter's 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 the 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 easy to solve. Here's the data." Which values for Hayden (of those given) are abnormal or borderline? Given Carrie's diagnosis, what is the most likely source/cause of Hayden's problem How did the "active agent" enter Hayden? Give two possible routes. If Carrie had continued to breast feed, how would that have affected Hayden's problem? 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 significant? c. Will long-term therapy (years or lifetime) be needed? Why or why not? d. Graves disease may have a heritable component. What future testing would you suggest for Hayden? 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. Dr. O'Dell explains that Carrie may need to have treatments with a short-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 accomplish here? Name a potential danger of this surgery (think anatomically). Could Carrie's problem be solved by a thyroid transplant from a matching donor? Explain. Autoimmunities are relatively uncommon. What usually happens to autoimmune antibody-producing during development?Explanation / Answer
1) When hayden just born, her Thyroxin level was at the maximum of the normal level. As she get 3 months older, her Thyroxin level changed to abnormal (22.2ug/dl). This is the condition called hyperthyroidism.
2) Hayden's problem is the over secretion of thyroid hormone, thyroxin. This condition is called Hyperthyroidism. The hyperthyroidism results from the Thyroid stimulating hormone(TSH) activity deficiency. This condition is most likely resulting from the disease called Grave's disease.
3) When Hayden was new born, her thyroxin level was normal. But when she started breast feeding for 3 months, the thyroxin level increased to abnormal level. It shows the way or reason how she got the condition of hyperthyroidism. Her mother is using medication for thyroid disease.