Part I—Initial Office Visit
You are six months into a year-long internship at Dr. Mara Siddiqui’s endocrinology clinic. So far, you’ve had a great experience with Dr. Siddiqui and you’ve seen patients with a wide range of endocrine issues. Today, you will shadow Dr. Siddiqui as she examines Angela Barber, a patient who was referred by her primary care physician. While waiting, you pull up Angela’s information on the computer and you find that she is a 52-year-old African American woman. Except for not feeling like herself over the last three months, she has no health issues.
Angela arrives at the clinic and you accompany the nurse to the exam room to get Angela’s vitals. Dr. Siddiqui comes into the exam room and asks Angela what has been bothering her. Angela tells the doctor that she has been cold, tired, fatigued, and just not feeling up to her normal activities. She has also gained roughly 20 pounds, even though she has been consciously monitoring her food intake. Angela can’t understand what is wrong—she went through menopause a year ago but she insists that the way she is feeling is not related to that change; she also has not changed anything else about her normal routine. Dr. Siddiqui listens to Angela and then examines her ears, eyes, and throat; she also listens to Angela’s lungs and heart, and palpates her neck and abdomen. All of Angela’s vitals and the outcome of the initial exam are within normal range. Dr. Siddiqui tells Angela that she suspects a thyroid issue and would like to order some blood tests.
Angela asks about the thyroid and why it is important. Dr. Siddiqui asks you to help explain this hormone system to the patient.
Questions to answer:
Diagram the hypothalamic-pituitary-thyroid axis. Make sure to include the feedback loops and spell out the hormone names.
What is the physiological role of thyroid hormones?
Does T3 or T4 play a larger role on the target tissues? Explain.
Part II—Research
Dr. Siddiqui tells Angela that her test results will be back in a few days and that she will give her a call when she knows something. You go home and do some research on various thyroid conditions so that you’ll have a good idea of what is going on with Angela. You find information on hyperthyroidism, hypothyroidism, goiter, Graves’ Disease, iodine deficiency (primary hypothyroidism), Hashimoto’s thyroiditis, and various tumors. You make a chart to help yourself sort out the different disorders.
Questions to answer:
Describe hyperthyroidism and hypothyroidism. List at least three symptoms of each.
What is a goiter?
If you gave a person with primary hypothyroidism (iodine deficiency) an injection of TSH would T3 and T4 levels increase? Why or why not?
Use the chart below to record whether the hormone levels are expected to be high, low, or either. For antibody/immunoglobulin and goiter, answer yes, no, or possible.
Part III—Test Results
Angela’s test results come back and Dr. Siddiqui gives you a copy to look over. Please use the data below and the initial information about Angela to answer the following questions.
Questions to answer:
Are any of Angela’s values outside the normal range? If so, which ones, and are they high or low?
Is Angela’s thyroid axis functioning properly? If not, does she have symptoms consistent with hypothyroidism or hyperthyroidism?
** Please answer questions in complete paragraphs**i have attached the assignment on a word document to include the graphs needed for the paper. PLEASE SEE ATTACHED**
