Ashley plopped her backpack onto the floor and sat across from Dr. Jones in the hard wooden chair.
Case Study
by Dr. Bruce Forciea.
Introduction
Ashley plopped her backpack onto the floor and sat across from Dr. Jones in the hard wooden chair. She noticed the finish almost completely gone from sections of the chair’s arms and wondered how many other students sat in her position with the same issue.
“So, Dr. Jones, I know I bombed the test again,” she said while avoiding eye contact. “I don’t know what to do. I study for many hours, but I can’t seem to remember or understand any of this physiology.”
“I remember you earned an “A” last semester, is there anything else going on in your life that may be interfering with your studies,” said a concerned Dr. Jones.
Ashley’s hand trembled as she adjusted her glasses. “Well, I’ve been having this stubborn sinus infection and headache for a while now,” she said as she reached for some Kleenex to wipe her nose.
“Have you been to the health clinic?” said Dr. Jones.
“Not yet, but I have an appointment tomorrow.”
The Clinic
Ashley sat in the exam room waiting for Dr. Smith. She could hear bits and pieces of conversations in the hall on the other side of the closed door. Dr. Smith burst into the room.
“Good morning, Ashley,” Dr. Smith said with a smile. “What brings you in today?”
Ashley related her symptoms of the past few weeks which included a runny nose, headaches, and a green discharge.
Dr. Smith began her examination.
“Hmm, looks like you have all the signs of a nasty sinus infection. Your eyes look like they are protruding a bit, however. Is this new? Also, have you lost weight or have been feeling nervous lately?”
“Yes doctor, but I thought it was just stress,” said Ashley, concerned.
“We’ll run some tests,” said Dr. Smith while tapping on her laptop keyboard.
A Few Days Later
“I have your test results,” said Dr. Smith.
“It looks like your TSH levels are low. T3 levels are very high and T4 levels are moderately high, so your thyroid gland is the problem. I’m going to refer you to an endocrinologist for a radioactive iodine uptake test to help confirm my diagnosis of Grave’s disease.”
Case Study Questions
Describe the function of the hormones of the thyroid gland.
Describe the feedback system for regulating thyroid hormones. How does this relate to Ashley’s thyroid hormone levels?
Describe the signs and symptoms of Grave’s disease.
Describe treatments for Grave’s disease. Include descriptions of the treatment and mechanisms of actions of any medications
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