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.
- Teaches yoga 3x/week
- LMP 3 years ago
- Denies hot flashes, night sweats or other menopausal symptoms
- 5’5″, 154 lbs, BP 145/88, P 60, R 16, T 97.2
- Heart: RRR no murmurs or gallop
- Lungs: CTA bilaterally
- Neck: Non-tender, mild goiter with rt side larger than left; denies difficulty swallowing or neck pain
- Skin: Dry with flaking noted
Based upon the previously provided data, the FNP suspects the patient has hypothyroid.
- Additional lab work reveals:
- T3 54 ng/dL
- T4 4.5 ug/DL
- Describe the pathophysiology of hypothyroid and hyperthyroid.
- What is the significance of the TSH and T3/T4?
- Identify risk factors for hypothyroid and hyperthyroid.
- What are the common manifestations of hypo and hyperthyroid?
- Discuss the pathophysiology of Graves disease.
- Discuss the pathophysiology of myxedema coma.
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