Let’s check your answers!

1. Thyroid hormone and calcitonin are the two hormones secreted by the thyroid gland.

2. Follicles are sphere thyroid cells adjoining core of a viscous substance called colloid.

3. Triiodothyronine(T3) and Tetraiodothyronine (T4) are the two active forms of thyroid hormone.

4. Calcitonin is secreted by parafollicular C cells and involved in the calcium homeostasis.

5. Thyroid gland is a hefty endocrine gland situated in the base of the neck and has a comparable form to that of the butterfly.

6. Thyroid hormone is concerned with regulation of the metabolic rate , neurologic development and numerous other body functions.

7. Calcitonin is a 32-amino acid linear polypeptide hormone that is produced in humans primarily by the parafollicular cells.

8. 150 ug/day is the recommended minimum intake of iodine per day.

9. Thyrotoxicosis is a result of excessive thyroid hormone ingestion or leakage of stored thyroid hormone from storage.

10. Thyroid Autoimmunity uses bioassay to determine the presence of autoimmune hyperthyroidism.

Case 1



What additional test/s can you suggest to diagnose the patient's disease?

The additional tests that can be performed to differentiate hyperthyroidism and hypothyroidism are the T3 Test, T4 Test, Total T4 Test which are increase in hyperthyroidism and TSH Level is decrease. While in hypothythoidism it is vice – versa. The T3 Test, T4 Test, Total T4 Test are decrease and TSH level is increase.

Based on the clinical manifestation presented what is your primary diagnosis?

The primary diagnosis of the patient’s is she is experiencing postpartum hypothyroidism which cannot be identified easily because the signs and symptoms of being pregnant with that of hypothyroidism are just the same. But after birth of the baby there is a noticeable retarded growth which is also a sign of deficiency in thyroid hormone.

What are the possible signs and symptoms of her disease?

According to Harrison’s Principle of Internal medicine, 17^th Edition the signs of hypothyroidism are dry coarse skin; cool peripheral extremities, puffy face, hands, and feet (myxedema), diffuse alopecia, bradycardia, peripheral edema, delayed tendon reflex relaxation, carpal tunnel syndrome, serous cavity effusions while the symptoms are tiredness, weakness, dry skin, feeling cold, hair loss, difficulty concentrating and poor memory, weight gain with poor appetite, dyspnea, hoarse voice, menorrhagia (later oligomenorrhea or amenorrhea).

Case 2

Aside from the test listed above what additional test can you suggest to diagnose the patient's disease?

Aside from serum TSH and autoantibody test T3 Test, T4 Test, Total T4 Test can be performed to confirm hypothyroidism. The presence of autoantibody indicates that the T- cell of the body attacks its own thyroid gland.



Based on the clinical manifestation presented what is your primary diagnosis?

Based on the clinical manifestations the patient is experiencing hashimotos’ thyroiditis which is a condition caused by inflammation of the thyroid gland. It is an autoimmune disease, which means that the body inappropriately attacks the thyroid gland--as if it was foreign tissue.

What are the possible signs and symptoms of her disease?

Symptoms of Hashimoto's thyroiditis include weight gain, depression, mania, sensitivity to cold, fatigue, panic attacks, bradycardia, tachycardia, high cholesterol, reactive hypoglycemia, constipation, migraines, muscle weakness, cramps, memory loss, infertility and hair loss.

Hashimoto's thyroiditis is often misdiagnosed as depression, cyclothymia, PMS, and, less frequently as bipolar disorder or as anxiety disorder. Testing for TSH and anti-thyroid antibodies can resolve any diagnostic difficulty. (wikipedia.org)

References:

Harrison’s Principle of Internal medicine, 17^th Edition

Pathologic Basis of Disease 7^th Edition, Robbinson et. al.

en.wikipedia.org/wiki/Hashimoto's_thyroiditis

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