Monday, April 11, 2016

Answers to Thyroid Function Case Analysis 2 - Questions


TFT CASE ANALYSIS 2

      1. A 41 YR OLD WOMAN COMPLAINED OF INCREASED SWEATING OVER THE PREVIOUS 3 MONTHS.  SHE ALSO STATED THAT SHE ALWAYS SEEMED NERVOUS AND HAD HEART PALPITATIONS AND HEAT INTOLERANCE.  SHE LOST 12 POUNDS OVER THE PAST 3 WEEKS AND HAD NONCRAMPING DIARRHEA.  ON EXAMINATION, HER SKIN WAS WARM AND MOIST, SHE HAD A PROMINENT STARE, AND SHE HAD TACHYCARDIA AT 140 BEATS PER MINUTE.  HER THYROID GLAND WAS DIFFUSELY ENLARGED WITH A SUGGESTION OF NODULARITY.

LABORATORY FINDINGS

      TT4 = 21.2 ug/dL ( 273 nmol/L)
      THBR RATIO = 2.0
      s-TSH = NONE DETECTED
      FT4I = 42.4 ng/dL ( 546 pmol/L)

QUESTIONS

      1. WHAT IS THE MOST PROBABLE CAUSE OF THESE SYMPTOMS AND LABORATORY RESULTS?

Hyperthyroidism with goiter

      2.  WHAT ADDITIONAL LABORATORY TESTING WOULD BE HELPFUL IN CONFIRMING THE DIAGNOSIS?

TT3 and FT3

      3.  WHAT IS THE SIGNIFICANCE OF THE s- TSH TEST?

It is the most sensitive test to confirm hypothyroidism or hyperthyroidism

      4.  WHAT CAUSES THE DISORDER?

Insufficient Iodine in the diet, dysfunctional thyroid gland


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