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Case Study

You are seeing a 53-year-old female patient for a wellness exam. She expresses concerns that she has regarding symptoms of fatigue and weight gain over the last year, despite a healthy diet and regular exercise. She states she had “some lab work done” and was concerned about the results. She brings a copy which shows a TSH of 93.

 

1. Teaches yoga 3x/week
2. LMP 3 years ago
3. Denies hot flashes, night sweats or other menopausal symptoms
4. 5’5″, 154 lbs, BP 145/88, P 60, R 16, T 97.2
5. Heart: RRR no murmurs or gallop
6. Lungs: CTA bilaterally
7. Neck: Non-tender, mild goiter with rt side larger than left; denies difficulty swallowing or neck pain
8. Skin: Dry with flaking noted

 

Based upon the previously provided data, the FNP suspects the patient has hypothyroid.

1. Additional lab work reveals:
2. T3 54 ng/dL
3. T4 4.5 ug/DL
4. Describe the pathophysiology of hypothyroid and hyperthyroid.
5. What is the significance of the TSH and T3/T4?
6. Identify risk factors for hypothyroid and hyperthyroid.
7. What are the common manifestations of hypo and hyperthyroid?
8. Discuss the pathophysiology of Graves disease.
9. Discuss the pathophysiology of myxedema coma.

 

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