Clinical 4: Thyroid

Question 1

Signs/Symptoms of Patient 1

Answer 1

1) Generalised itching with no rash
2) Weight loss (7-8kg in 1.5 months)
3) Retracted eyes
4) Hungry all the time
5) Tremor
6) Wake up Tired
7) Hot all of the time
8) Defecated 2-3 times a day
9) Palpitations
10) Anxious about everything/nothing
11) Dry eyes

Question 2

Familial history of patients with thyroid problems

Answer 2

Most people with autoimmune disease have the same HLA makeup, but 1 family may get thyroid disease whilst the other does not.

Question 3

10% of patients have an _____

Answer 3

itch

Question 4

What should you do after treatment?

Answer 4

Regular blood test. 50% chance of relapse

Question 5

Patient 2 Signs/Symptoms

Answer 5

1) Sore eye
2) Palpatations
3) Tachycardia
4) Weight-loss (20kg)
5) Weakness (biceps is fine, but shoulder muscles was weak)
6) Arthritis

Thyroid tumour and on-going thyrotoxicosis
-16cm.

Question 6

Treatment drug

Answer 6

Carbmizole

+ steroids (for eye______)

Carbimazole is used to treat hyperthyroidism. Carbimazole is a pro-drug as after absorption it is converted to the active form, methimazole. Methimazole prevents thyroid peroxidase enzyme from coupling and iodinating the tyrosine residues on thyroglobulin, hence reducing the production of the thyroid hormones T3 and T4 (thyroxine).

Question 7

What causes palpatations in abnormal-thyroid patients

Answer 7

Palpatations are caused by thyroid hormone effects on the heart

Question 8

What is Proptosis?

Answer 8

abnormal protrusion or displacement of an eye or other body part.