Regis College Thyroiditis & Thyroid Stimulating Hormone Test Discussion

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convyrl1969

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Regis College

Description

Same as previous assignment.

Mary T. is a 29 year old referred to you because of a routine screening test, which revealed markedly elevated cholesterol. ROS identified dry skin, 10 lb. Weight gain, regular but heavy menses, easy and frequent bruising, milky breast discharge and fatigue. Meds include multivitamin and oral contraceptives.

  1. What laboratory tests would you order for her? Mary further explains that she has had a stressful year. Her mother, whom she had cared for during the terminal phases of breast cancer died. She took several months off from work due to depression following her mother’s death. She now works full-time as a travel agent and discusses having difficulty concentrating. She works out of her home and cares for her 4-year-old daughter.
  2. Discuss the normal grieving process in view of her symptoms? PE: BP 120/72, Weight 145, pounds Height 61 inches Skin: dry, scaly, slight loss of scalp hair, several bruises on arms and legs, diminished DTRs, thyroid slightly enlarged. Labs: glucose and electrolytes WNL, Total Cholesterol 267/LDL 178/HDL 40/Triglycerides 167, HGB 11, HCT 33.4, TSH 20.
  3. List 5 differential diagnoses based on the available data.
  4. How would you explain your findings to her? What will you tell her about her labs?
  5. What follow-up labs will you order and when?
  6. How do you plan to treat her cholesterol? Her fatigue?


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Explanation & Answer

All sorted for you buddy ^^!

Running Head: THYROIDITIS

1

Thyroiditis
Student’s Name
Institution’s Affiliation

2

THYROIDITIS
Laboratory Tests for Mary

Looking at these findings, Mary T. presents with the symptoms and signs of thyroiditis,
an autoimmune disease, which is the most frequent cause of hypothyroidism. As such, it is
critical to carry several laboratory tests that form the basis of diagnosing and managing the
disease.
TSH (thyroid-stimulating hormone) Test
This is the first laboratory test to order for Mary. It is recommended that TSH tests
should be the first-line screening tests in such a case. Mincer and Jialal (2019) assert that the
diagnosis of primary hypothyroidism can be confirmed through TSH tests. During these tests,
primary hypothyroidism is often confirmed if thyroid-stimulating hormone levels are elevated. In
most cases, the typical techniques that are used to detect TSH levels include the highly sensitive
third-generation immunometric assays (non-competitive or sandwich assays) (Soh and Aw,
2019). However, clinicians should not rely on TSH tests only during the initial phases of
diagnosing hypothyroidism. In addition to carrying other tests, it is plausible to carry out the
TSH tests again to affirm the diagnosis. However, the TSH test should remain the best initial
test, especially when cost containment and cost-effectiveness are matters of concern.
Free (Thyroxine) T4 Test
The free T4 test would be another test to order for her. According to Soh and Aw (2019),
the absence of actual thyroid dysfunction, abnormal total thyroid hormone levels result from
conditions that affect TBG levels, such as acute illnesses or pregnancies, since thyroid hormones
are typically embedded w...


Anonymous
Just what I needed…Fantastic!

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