- Edna is a 42-year-old mother of two girls. She has been feeling very sluggish lately and finds it hard to get out of bed in the morning, even after a full night’s sleep. She is fatigued throughout the day and has to compensate with a lot of caffeine. She’s gained about 5 pounds this month, but attributes that to all the workouts she’s been skipping lately. Her partner keeps noticing and mentioning how cold Edna’s hands are, even though it is the middle of summer. Edna sees her doctor to find out what is wrong. Her physician takes her vital signs before doing further testing. Here are her results: BP 124/74, Pulse 52, Temperature 98.2 F, Height 5’8”, and Weight 178 pounds.
Edna’s doctor is worried about her endocrine function. Which of the following glands is most likely causing her symptoms?
- Edna’s symptoms are similar to those present in Grave’s disease.
- During Edna’s physical exam, her physician notes an enlargement of her thyroid gland. What is this called and why is it important in her case?
- Edna’s physician suspects that she may have hypothyroidism. Which of the following tests would be the first step to help confirm that diagnosis?
|Ultrasound of the thyroid|
|Fine needle biopsy|
|Blood test for thyroxine and TSH levels|
- Edna’s test results showed that her T4 level was below normal. Why might her TSH level be elevated?
- If Edna’s condition goes untreated, she may experience more severe symptoms. List 3 symptoms (other than those given in her history) that often accompany untreated hypothyroidism.
- Which of the following is the most likely and effective form of treatment for Edna’s condition?
|Life-long oral medication, such as levothyroxine|
|Two week prescription of thyroid medication|
|Dietary changes, including elimination of caffeine|
- Why would Edna’s doctor inquire about her iodine intake? (Explain why iodine is pertinent in this case and how it affects the thyroid.)
- If Eda is prescribed a synthetic thyroid medication, which of the following would be a sign that her dosage is too high?
|Decrease basal metabolic rate|
- If Edna’s symptoms are related to Hashimoto’s thyroiditis, should her daughters be concerned about their own thyroid health? Why or why not?
- Elaine just turned 50 years old and had all of the recommended screening tests at her annual physical. She was surprised to learn that she had an abnormal blood glucose result. She has had blood sugar tests in the past and her results were always within normal limits. Her doctor asked her to follow-up with further testing.
Elaine’s doctor wants to know more about her family history of endocrine disorders. Why would her physician ask her about this?
- Which of the following fasting blood glucose results would be considered normal?
- Given Elaine’s history of normal blood glucose tests, it is most likely that she had Diabetes Mellitus Type I.
- Elaine’s nurse explains that her follow-up appointment will include a fasting blood glucose test. Why is it important to fast before her blood draw? How does this help diagnose diabetes?
- After her abnormal test results, Elaine’s physician asks more questions about her history. Which of the following would NOT be related to a diagnosis of diabetes?
- If Elaine is diagnosed with Diabetes Mellitus Type II, which of the following is NOT true?
|Insulin injections will likely be required.|
|She will need to make lifestyle changes, including changes to her diet and exercise routine.|
|Her body cells have likely become insulin resistant.|
|If she does not treat her condition, she could develop metabolic ketoacidosis.|
- What is a glucose tolerance test? Explain briefly how this test works and what it is used for.
- Insulin is responsible for which of the following functions?
|Increases sugar levels in bloodstream|
|Stimulates the breakdown of glycogen to glucose|
|Transports glucose into cells|
|Stimulating the breakdown of fat and proteins into glucose|
- The pancreas secretes glucagon when the body is in a state of hyperglycemia.
- Elaine’s doctor recommends supplementing her lifestyle changes with medication. Which of the following statements is true regarding diabetes treatment?
|Diabetes Mellitus Type II is always treated with insulin injections.|
|For patients with insulin resistance, medication to increase cell sensitivit can reverse the problem.|
|Medication to stop the pancreas from producing insulin is effective.|
|Even though Elaine’s symptoms are mild, her doctor will recommend a permanent insulin pump because of her age.|