Question

determine which part of the endocrine system could be experiencing problems. List some other info that could confirm or rule out your initial diagnosis (test you might be able to run or questions to ask the patient or relatives). Explain your reasoning.

A 27 year old female enters the clinic complaining of fatigue, fluid retention (especially in her face), and a cold that she just cannot kick. She is studying for her midterms (she is a first year physician's assistant student) and her roommate finally convinced her to come in; because she is always sick and always grumpy.

Answer 1

ANSWER

The probable intial diagnosis from provided information is HYPOTHYROIDISM.

In this primary endocrine gland thyroid is facing problem as thyroid gland is not able to produce enough thyroid hormone.

EXPLANATION:

The thyroid is a butterfly-shaped gland that sits in front of the neck. Thyroid hormones play a vital role in regulating metabolism and energy use and affect almost all of the body’s organs. Hypothyroidism is underactivity of the thyroid gland that leads to inadequate production of thyroid hormones and a slowing of vital body functions.

• FATIGUE - Body's energy production requires certain amounts of thyroid hormones, a drop in hormone production leads to lower energy levels, causing you to feel weak and tired
• FLUID RETENTION IN FACE - The thyroid gland releases hormones that play a role in managing fluid levels. People with condition that affects the thyroid gland may therefore experience water retention.
• SENSITIVITY TO COLD - Reduced level of thyroid hormones slow down body metabolism, which can lead to a drop in core body temperature. As a result such, people with hypothyroidism feel cold all the time or have a low tolerance of the cold even in warm atmosphere.
• SICK AND GRUMPY - Changes in levels of thyroid hormones can make patient become sluggish and get mood swings.

OTHER QUESTIONS TO BE ASKED ARE :

Whether patient experiencing

1. Increased sleeping.
2. Thinning of hair
3. Flaky skin /dry skin
4. Loss of appetite
5. Weight gain
6. Brittle nails
7. Constipation

DIAGNOSTIC TESTS TO CONFIRM THE CONDITION :

As symptomatic experience alone cannot taken into account to confirm a diagnosis. Patient need to undergo specific laboratory tests.

1. Thyroid function test

In this it measure TSH (thyroid stimulating hormone) , T4 (thyroxine) , and T3 levels in blood.

A high level of TSH and a low level of T4 in the blood represents an underactive thyroid.

2. USG of Thyroid gland may be suggested - It may show enlarged thyroid gland.