Sam Miller, age 26, who is training to run her fifth marathon, has gradually increasing dyspnea...

Sam Miller, age 26, who is training to run her fifth marathon, has gradually increasing dyspnea on exertion, fatigue, and weight gain. She has no children and is not now pregnant. Her nurse practitioner suspects a thyroid hormone disorder.

Answer the following questions about Marty’s pathophysiology.

a. What are other symptoms about which you should ask Sam? Why?

b. If Sam has developed hypothyroidism, what might be found on examination?

c. The nurse practitioner drew blood to measure Sam's TSH levels. What gland secretes TSH? If Sam has hypothyroidism, what do you expect the TSH results to be? Why?

d. When her thyroid disorder was undiagnosed, was Sam at risk for thyroid storm? Why, or why not?

Expert Solution

A The other symptoms we can ask him include whether he has sensitive to cold, depression,about bowel movements, muscle cramps,about muscle strength and definitely about sexual life also, because all these are associated with thyroid disorder.

B.if he has developed hypothyroidism on examination we will find definitely symptoms like

* Tiredness

* Weight gain

* Depression

* Constipation

* Slow movements and thoughts

* Muscle ache, weakness, muscle cramps

* Dry and scaly skin

* Irregular periods or heavy periods

Along with this there will be variation in thyroid hormone level.

C. TSH is secreted by pituitary glands, if Sam has hypothyroidism there will be increased level of serum TSH. Because in hypothyroidism pituitary gland produces more TSH in am effort to stimulate thyroid gland to produce more thyroid hormones.

D. If thyroid disorder especially hypethyroidism left untreated it will surely lead to thyroid storm. In the case of Sam his symptoms looks like hypothyroidism, so there is les chance to get thyroid storm. If hypothyroidism left untreated it will lead to serious complications like slow heart rate, hearing loss, anaemia,low pitched or hoarseness of voice etc

Nightingale answered 2 years ago

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