Monday, May 9, 2016

Answers to Thyroid Function Test, Case Analysis 4


CASE ANALYSIS 4

      AN APPARENTLY HEALTHY 33 YR-OLD WOMAN UNDERGOES THYROID TESTING WITH THE FOLLOWING RESULTS:  FT4 = 1.2 ng/dL, s-TSH = 15 uU/mL.  NO GOITER OR ANY OTHER ABNORMALITY IS NOTED.  THE PHYSICIAN IS CONCERNED, BUT DECIDES TO FOLLOW THE PATIENT FOR EVERY SIX MONTHS.  SIX MONTHS LATER THE PATIENT’S FT4= 1.1 ng/dL, s –TSH = 25 uU/mL.

QUESTIONS

      1.  WHAT CLINICAL STATE IS THE PATIENT APPARENTLY EXHIBITING? DEFEND YOUR ANSWER?

      Secondary or tertiary hypothyroidism.

      2.  WHY IS THERE CONCERN OVER THESE RESULTS?

      There may  be dysfunction in the anterior pituitary.

      3.  WHY WOULD MOST LABORATORY THYROID TESTS NOT BE USEFUL IN THIS CASE?

      Because the master gland is affected.

      4.  WHAT LABORATORY TEST WOULD BE USEFUL? WHY?

      Stimulation tests because it would determine what particular organ is dysfunctional.


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