Graves Disease and Goiter

The Case of the Sweaty Salesman – Michael is a 30-year old salesman who spends approximately 4 days each week traveling to visit with customers in his region. During his routine physical he casually mentions to his physician that he seems to be sweating more profusely than normal and most rooms that once were comfortable are now too “hot”. He thought that it was simply due to the change in seasons and companies being slow to turn down the thermostats from the winter temperatures, however this problem seems to persist even when he is at home. A room that his wife and children find to be comfortable causes him to sweat profusely. Michael also reports that he seems to be loosing weight even though his appetite has increased. He also complains that he has a shortened attention span and that he always wants to be moving around.

Despite the fact that he feels fatigued, Michael claims to have difficulty sleeping and seems to have more frequent bowel movements, occasionally accompanied by diarrhea. The physician checks Michael’s medical history and finds that indeed he has lost 15 pounds since his last physical. Wanting to rule out the possibility of infection with the human immunodeficiency virus (HIV), the physician asks Michael questions about his sexual history and practices and finds that he is not at risk for HIV infection. Also in checking his chart, the physician finds that Michael has a negative history for chronic illnesses, does not smoke, and has a low risk for cardiovascular disease. He does however have a positive family history for autoimmune diseases. His father suffers from idiopathic thrombocytopenia, his mother has been diagnosed with rheumatoid arthritis and his oldest sister was recently diagnosed with systemic lupus erythematosus. Results of Michael’s physical examination were within normal ranges with the exception of the following: he demonstrated tachycardia, loud heart sounds, and apparent cardiac arrhythmias accompanied by slight hypertension. These arrhythmias were confirmed by electrocardiogram to be supraventricular in origin.

Don't use plagiarized sources. Get Your Custom Essay on
Graves Disease and Goiter
Just from $13/Page
Order Essay

Michael’s eyeballs appeared large and protruding and his hair was fine and soft. He was also beginning to demonstrate some degree of alopecia. Michael was also observed to have palmar erythema. Palpation of the neck revealed the presence of goiter. Results of blood tests indicated elevated concentrations of thyroid hormones (thyroxin and triiodothyronine), hypercalcemia, and decreased circulating concentrations of lipids. Based on the physical characteristics and the results of the blood tests, Michael’s physician suspected that Michael was suffering from some form of hyper-thyroidism and sent him to an endocrinologist to confirm the initial diagnosis. Following the initial consultation and examination, the endocrinologist ordered tests to determine whether Michael was indeed hyperthyroid. The test results indicated an elevation in the concentration of thyroid hormones in the blood and the presence of thyroid-stimulating antibodies.

These antibodies specifically stimulate the thyroid gland by binding with the thyroid stimulating hormone receptor located on the plasma membrane of the follicular cells of the thyroid gland. Based on these results, the endocrinologist concluded that Michael had Grave’s disease, a form of hyperthyroidism believed to be autoimmune in nature. Michael was presented with a number of possible treatment options.

These included treatment with chemicals (propylthiouracil and methimazole) that decrease the production of thyroid hormones by the thyroid gland, radioisotopic destruction of the thyroid gland by the use of 131I, and surgical removal of the thyroid gland. After considering all the options, especially the possible effects of radiation on gamete development, Michael chose surgery. Following successful surgery, Michael was prescribed synthetic thyroid hormone to ensure that his body was receiving adequate thyroid hormone and told to return within 2 months for a follow-up evaluation of circulating thyroid hormone concentrations. He was also cautioned to carefully monitor his calcium intake.

1 Define the bold terms in the text. autoimmune diseases: thrombocytopenia: rheumatoid arthritis: alopecia: erythema: hypercalcemia: hyperthyroidism:

2 Thyroid hormones exert their effects on cells in a manner similar to steroid hormones; describe the mechanism of action of thyroid hormones.

3 Evaluate why an imbalance in thyroid hormones have such widespread effects on the body?

4 Propose two ways that allow diagnosis of Michaels symptoms as goiter.

5 Analyze why calcium homeostasis would be impaired in response to removal of the thyroid gland?

6 Explain why 131I could be used to specifically destroy the thyroid gland and have minimal effects on other cells and tissues in the body?

7 Knowing that Michael and his wife may want to have more children infer/ explain why it was ruled out to use highly radioactive isotope for the destruction of the thyroid gland?

8 Define the terms Graves Disease and goiter and explain what causes each. [Goiter has more than one cause.]

Essaywriters4me

Calculate The Price Of Your Paper

Pages
{{total || ""}}

Why Choose Us

Top Quality and Well-Researched Papers

We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university or professional, and we will assign a writer who has a respective degree.

Professional and Experienced Academic Writers

We have a team of professional writers with experience in academic and business writing. Many are native speakers and able to perform any task for which you need help.

Free Unlimited Revisions

If you think we missed something, send your order for a free revision. You have 10 days to submit the order for review after you have received the final document. You can do this yourself after logging into your personal account or by contacting our support.

Prompt Delivery and 100% Money-Back-Guarantee

All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.

Original & Confidential

We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.

Customer Support 24/7

Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.

Freebies
Our FREE services
Every order comes with these awesome features.
Order Now
Money Back Guarantee
FREE Best essay writer across your subject
FREE Cover page and bibliography
FREE APA/MLA/Chicago formatting
FREE Free Revisions
FREE 24/7 customer support hotline and chat

Essays

Essay Writing Services

No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.

Admissions

Admission and Business Papers

An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.

Editing

Editing and Proofreading

Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.

Coursework

Revision Support

If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.