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Case #1.

1.What is the likely diagnosis, and what symptoms made you consider that diagnosis?

  She appears to suffer from hypothyroidism. Hypothyroidism is characterized by an underactive thyroid gland (McCrane & Huether, 2019). When the thyroid organ does not produce enough thyroid hormones, the condition is known as hypothyroidism. Fatigue, increased sensitivity to cold, dry skin, constipation, weight gain, a deeper voice, failure to palpate her thyroid gland, and a sluggish response when eliciting the deep tendon reflex are the symptoms considered before making the diagnosis.

2. Which lab data supported the diagnosis?

TSH level is 0.9 mU/ml which is within the normal range, but T4 level is low (3.4 ug/dl) indicating an objective diagnosis of hypothyroidism. . Her cholesterol is another sign that she has hypothyroidism. Her cholesterol level is 275 mg/dl, and she has a low thyroid level, which affects the liver’s ability to absorb cholesterol. This patient’s cholesterol level is higher than normal, which may suggest hypothyroidism. Since the thyroid is involved in so many of the body’s functions, she will require thyroid replacement for the rest of her life.

  1. Explain-Hypothalamic-Pituitary-Thyroid axis and interrelationship.

The hypothalamic-pituitary-thyroid axis regulates metabolism and responds to stress as part of the neuroendocrine system (Ortiga-Carvalho et al., 2016). The thyroid hormones thyroxine and triiodothyronine are detected by the hypothalamus. The hypothalamus responds to low thyroid levels by releasing thyrotropin-releasing hormone (TRH). The anterior pituitary is stimulated by TRH to generate thyroid-stimulating hormone. Before the hypothalamus senses that blood levels have returned to normal, the thyroid produces thyroid hormone. Negative feedback is used to keep this machine running (Ortiga-Carvalho et al., 2016).