patient is a 51-year-old maintenance worker referred by his doctor because of a

Question

patient is a 51-year-old maintenance worker referred by his doctor because of a six month history of weight loss, excessive a mild tremor of the outstretched hands. The thyroid gland was palpable but not significantly enlarged. There were no eye abnormalities. sweating, unusual fatigue and palpitations. On examination the patient seemed tense and had Lab Data: Test 1131 uptake FT4 TSH Result 34% 45 0.1 Reference Range (8-25%) (9-27 pmol/L) (0.32-5 mUL) Please answer the following questions associated with the above case: What is the likely diagnosis? Explain by incorporating both patient signs and symptoms as well as test result interpretation in your answer. a. b. Is the disorder primary ot? Explain your answer

Explanation / Answer

a) The likely diagnosis in this patient is hyperthyroidism. The patient is experiencing symptoms like weight loss, excessive sweating, fatigue and palpitations. All of these point towards increase in thyroid hormone levels as thyroid hormones increase basal metabolic rate in the whole body leading to these symptoms. The lab results also show increase in FT4 levels. So, this is a case of hyperthyroidism.

b) The disorder is likely to be primary hyperthyroidism. This is because only FT4 levels are increased and TSH levels are below normal. So, there is an involvement of only thyroid gland without involvement of pituitary or hypothalamus or any TSH secreting Timor's. The primary pathology is mainly limited to thyroid gland. So, this is likely to be primary hyperthyroidism.

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