Endocrine case study The Case of the Sweaty Salesman?

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Endocrine case study The Case of the Sweaty Salesman?
Endocrine case studyThe Case of the Sweaty SalesmanChief Complaint: In a routine physical exam Michael, a thirty year old salesman complains of excessive sweating, intolerance to heat, irritability, shortened attention span, difficulty in sleeping, weight loss with increased appetite. He does not smoke, practices safe sex, has no family history of cardiovascular disease. He has a 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.Physical findings: (1) 15 lb weight loss since last physical; (2) tachycardia with slight hyperthension; (3) protruding eyeballs (exothalmic); (3) some degree of alopecia and palmar erythema; (4) palpitation of the neck revealed the presence of goiter.Based on the physical findings his doctor did some blood tests and sent him to an endocrinologist. The endocrinologist diagnosed _____________ , and suggested several treatment options. These included treatment with chemicals (propylthiouracil and methimazole) that decrease the production of thyroid hormones by the thyroid gland, or radioisotopic destruction of the thyroid gland by the use of 131I, or surgical removal of the thyroid gland. After considering all the options, especially the possible effects of radiation on sperm 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.Blood test results: Free T4: 20 mcg/dL (normal range: 4.8 to 10.4 ug/dl). TSH: 1.5 mIU/L (normal range: 0.3 3.0 mIU/L) Calcium: 15 mg/dL (normal range: 8.5 10.2 mg/dL) Positive for thyroid autoantibodies.This is the question please help1. What is your diagnosis?2. Define the bold terms in the text. 3. Why is the T4 levels elevated? 4. Thyroid hormones exert their effects on cells in a manner similar to steroid hormones; describe the mechanism of action of thyroid hormones.5. Why would an imbalance in thyroid hormones have such widespread effects on the body? 6. Why was goiter observed in Michaels case? 7. Why would calcium homeostasis be impaired in response to removal of the thyroid gland?8. Why is 131[I] used to specifically destroy the thyroid gland and have minimal effects on other cells and tissues in the body? 9. Given that Michael and his wife may want to have more children, why was 131[I] treatment ruled out
Mm... Best of luck! http://ideas-gift.info/12128/autoimmune-diseases
Graves disease?


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