Question

1. A 77-year-old woman was admitted to the hospital for rectal bleeding. The patient was noticed to be lethargic and complains about the hospital air conditioning being too cold. Clinical examination revealed a puffy face with some periorbital edema, slow heartrate (58 beats/min), loss of eyebrows and non-pitting edema. Her temperature was 35oC, and blood pressure was recorded as150/90mmHg. Her thyroid gland was firm and non-tender. She explained some weight gain over the past years. Thyroid blood work showed serum TSH of 102 microU/ml and total T4 of 0.9 microgram/dl.

Part 1: What is the likely diagnosis of the patient?  

Part 2: Explain how iodine is absorbed, distributed and excreted out?

Part 3: Identify 2 methods in determining thyroid hormones levels in blood.

Answer 1

HYPOTHYRODISM -It is caused due to the low thyroid activity.The patients serum TSH is 102 micro U/ml,which means she is having high TSH levels and she is having a total of T4 is 0.9 microgram /dl which means it is normal.

iodine is absorbed in gastrointestinal tract.Before it is absorbed iodine is converted ito iodide.The iodide is used by the thyroid gland for the synthesis of thyroid hormones and kidney excretes iodine with urine.The excretion of iodine in the urine is a good measure of iodine intake.

We can detect thyroid hormones in the blood by TSH test,T4 .TSH is a blood test to measure the thyroxine .If the TSH Is high we have hypothyrodism.In T4 test the free T4 and free T4 index are used to test in combination with TSH test.This is used to detect the function of the thyroid gland.Normal TSH level is 0.4 to 4.0 milli international units of hormones per litre of blood.