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.

Thyroid Function Test, Case Analysis

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?

•      2.  WHY IS THERE CONCERN OVER THESE RESULTS?

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

•      4.  WHAT LABORATORY TEST WOULD BE USEFUL? WHY?

CHECK ANSWERS HERE