Saturday, April 16, 2016

Answers to Thyroid Function Test (TFT), Case Analysis 3


CASE ANALYSIS 3

      A 59 YEAR OLD MAN WHO HAS BEEN DIAGNOSED WITH ACUTE RESPIRATORY DISTRESS SYNDROME SHOWED SYMPTOMS OF HYPOTHERMIA, COOLNESS IN THE EXTREMITIES, DECREASED BLOOD PRESSURE AND PULSE, FATIGUE, AND DELAY IN REFLEX TIME.  A THYROID PROFILE WAS ORDERED WITH THE FOLLOWING RESULTS:

LABORATORY FINDINGS

      FT4 = 4.0
      s.-TSH = 1.0 uU/mL

QUESTIONS

      1.  FROM THE CASE HISTORY AND THE LABORATORY DATA, WHAT IS A LIKELY DIAGNOSIS?

      Possibly euthyroidism or hypothyroidism, but since s-TSH is normal, it might be borderline case or a physiological factor is present.

      2.  WHAT ADDITIONAL LABORATORY TEST/S WOULD BE APPROPRIATE?

      FT3, TT3, Stimulation tests, TBG, or perform a delta check (repeat tests)

      3.  WHAT ADDITIONAL INFORMATION CONCERNING THE PATIENT WOULD BE HELPFUL IN INTERPRETING RESULTS?

      Patient’s history, surgical procedures done, drugs taken

      4.  IS TREATMENT FOR THYROID DISORDER INDICATED?

      Observe first for a few weeks and wait for additional tests and delta checks.


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