Question

Assume that you work in the endocrinology clinic of a university hospital. Four patients treated at the clinic today had
thyroid conditions. What thyroid condition do you think each of the following patients has? How should it be treated?

a.	Patient A is a 44-year-old male presenting with a round, puffy face, dry skin and hair, hypotension, anemia, drowsiness, and intolerance to cold.
b.	Patient B is an 18-month-old female presenting with growth failure, delayed motor and mental development, delayed tooth eruption, and intolerance to cold.
c.	Patient C is a 25-year-old male presenting with anxiety, weight loss, muscle weakness, tachycardia, and intolerance to heat.
d.	Patient D is a 65-year-old female presenting with nausea, vomiting, headaches, and heart arrhythmia.

Answer 1

a). Patient clinical feature indicate to hypothyroidism condition in patient

1st test done in patient is thyroid profile t3 ,t4,and tsh level

If t3and t4 level are low and tsh level is high , primary hypothyroidism patient

If tsh also low , secondary hypothyroidism patient

Primary and secondary hypothyroidism patient 1st treat with levothyroxine, suggest to use iodised salt

b). 18 month old baby indicate hypothyroidism symptoms

So test for thyroxin level in blood

If low and confirm hypothyroidism condition start levothyroxine

c). Patient symptoms indicate hyperthyroidism condition

If primary hyperthyroidism treat with antithyroid drug like proplythiourecil and carbimazole

Thyrodectomy

Radio iodine (I -131) ablation

d) patient symptoms are indicate thyrotoxicosis

For treating arrhythmia given propronol (beta blocker)

Given ptu and carbimazole antithyroid drugs