Clinical Case Based Learning Discussion

Like many other organs and cells in the body, the heart is affected by decrease secretion of thyroid hormone. The heart mainly relies of T3, for it is the hormone that is transported into the myocytes. T3 binds to thyroid hormone receptors, which is the start of its many cellular actions. The activation of T3 in the myocytes is responsible for systemic vascular resistance, heart rate, contractility, and blood volume. In primary overt hypothyroidism, there is a hyposecretion of T4 and T3, which affects the cardiovascular hemodynamics. If there is not a sufficient amount of T4 to convert to T3, then there is not enough T3 available for the myocytes to carry out their cellular reaction. As a result, there is a decrease in cardiac output and cardiac contractility with an increase in peripheral vascular resistance. People with cardiovascular dysfunction due to primary overt hypothyroidism typically present with bradycardia, hypertension, dyspnea on exertion, and edema. However, most of the cardiovascular dysfunction responds well with thyroxine replacement therapy (Danzi;

The thyroid is a part of the endocrine system. The thyroid produces two hormones that affect metabolism, heart function and brain development. The hormones also helps regulate body temperature, weight and skin dryness. The two hormones that the thyroid secrets is triiodothyronine (T3) and thyroxine (T4). Thyroid-Stimulation hormone (TSH) is secreated by the pituitary gland, also part of the endocrine system, regulates the production on thyroid hormoes. If thyroid hormones are low the pituitart gland releases more TSH and if the thyroid hormones are hign less TSH is released. If someone is has Hashimoto’s disease the function of the thyroid and pituitary gland is affected and starts to decrease the thyroid hormones in the body and causes the pituitary gland to release more TSH into the

Thyroid Function Tests: The thyroid’s job is to make thyroid hormones, which are secreted into the blood and the carried to every tissue in the body. The major thyroid hormone secreted by the thyroid gland is thyroxine, also called T4 as it contains four iodine atoms. T4 is converted to T3 (triodothyronine) by removal of iodine atom. It occurs mainly in liver and in brain. The amount of T4 produced is controlled by another hormone which is made in the pituitary gland located at the base of brain, called thyroid stimulating hormone (TSH). The amount of TSH is in the blood depends on the amount of T4 that the pituitary sees. If the pituitary sees very little T4, then it produces more TSH to tell thyroid gland to produce more T4.When T4 in the bloodstream goes above a certain level, the pituitary’s production of TSH is shut off. The thyroid and pituitary act like heater and a thermostat. If it’s cold the thermostat reads the temperature and turns on the heater. Thus, the thyroid and pituitary, like heater turn on and off. T4 and T3 circulate almost entirely proteins, and when these proteins change their level in the blood, there is change in T4 and T3 levels.

Primary hypothyroidism is “caused by the inability of the thyroid gland to make T3 and T4” (Hurd, 2006). It is the inability to make and retain sufficient amounts of T3 and T4, the common thyroid hormones. Secretions are controlled by a negative feedback mechanism, which controls the thyroid-stimulating hormone (TSH) from the pituitary, which then stimulates T3 and T4 secretions (Wiersinga, 2014). Normal functions of the thyroid hormones are to maintain the basal metabolic rate, stimulate oxygen consumption, absorb carbohydrates from the intestines, regulate lipid metabolism, as well as activating the next phase of the hair growth cycle (Melmed, 2011)(Contreras-Jurado, 2015).

In a normally functioning body, Thyroxine (T4) and Triiodothyronine (T3) are hormones produced by the thyroid gland. They help control the rate at which the body uses energy and are regulated by a feedback system. Thyrotropin or Thyroid-Stimulating Hormone (TSH) from the pituitary gland stimulates the production and release of T4 (primarily) and T3 by the thyroid. Most of the T4 and T3 circulates, bound to protein, in the blood. A small percentage is free (not bound).

The thyroid gland, or more simply thyroid, is one of the largest endocrine glands in our body. The thyroid gland is found in the neck, below the thyroid cartilage. This gland is a vital important hormonal gland which is responsible for metabolism, growth and helping the human body. It helps to regulate many body functions by constantly releasing hormones into the bloodstream. There are two types of dysfunctions in the thyroid: hyperthyroidism and hypothyroidism. According to Dr. James Parker, hypothyroidism results from a deficiency of pituitary thyroid-stimulating hormone. The main hormone produced by the thyroid gland is called Thyroxine. Thyroxine acts

Patient M was admitted to the local hospital after presenting with abdominal pain for 2/7 days, vomiting and temperature of 37.9, Patient M was diagnosed with a perforated appendicitis. In New Zealand over 10,000 are admitted with acute appendicitis (Hawker, 2014, p.40) and is one of the most common surgical emergency of the abdomen (Craft, Gordon, & Tiziani, 2010, p.819).

Within the endocrine system, the thyroid gland plays an important role on daily function and activity. The thyroid gland is a butterfly-shaped gland located in front of the neck, right below the larynx. The thyroid gland produces thyroid hormones, primarily T3 (thyroxine) and T4 (triiodothyronine) (NIDDK, 2013). It is very important that the body produces the appropriate amount of thyroid hormones because these hormones affect nearly every organ in the body. More specifically, thyroid hormones regulate an individual’s metabolism such as heart rate, energy use, energy level, and protein synthesis (Family Doctor, 2014).

Thyroid storm is an acute exacerbation of hyperthyroidism and is a life-threatening situation that should be treated immediately. Although this is a relatively rare condition, the mortality rate is 20% which is often caused by multi-organ failure or congestive heart failure.3 Common triggers of thyroid storm include pre-existing Grave’s disease, radioactive iodine treatment, surgery, trauma, sepsis, excessive thyroid hormone ingestion, and withdrawal from anti-thyroid medications.3 Nick hadn’t experienced any of these, but he has a history of Celiac disease which is an autoimmune disorder and may be linked to other autoimmune disorders, such as undiagnosed Grave’s disease (hyperthyroidism).

Very well written SOAP notes. Your input on your plan to treat this patient is very informative. I agree with you that based on the symptoms described in the scenario, the most rational diagnosis would be appendicitis. However, the signs and symptoms of appendicitis differ among patients. Abdominal pain is the most common symptom. Usually patients with appendicitis tend to show involuntary guarding, tenderness in the right lower quadrant and rebound tenderness (Dains, Baumann, Scheibel, 2016). Full physical and systemic examination of the abdomen are essential in the diagnosis of appendicitis. Acute appendicitis is an inflammation of the appendix due to infection. Appendicitis occurs when the vermiform appendix becomes inflamed which commonly

Binding of TSH to thyroid gland receptors leads to release of thyroid hormones, when there are elevated levels of these hormones there is a reaction that occurs to the hypothalamus that signals it to decrease TRH secretion and therefore synthesis of TSH begins (Lee 2015). Iodine is required for the synthesis of thyroid hormone. “Inorganic iodide is transported into the gland by an iodide transporter, convert to iodine, bound to thyroglobulin by the enzyme thyroid peroxidase, all which is a process known as Organification” (Lee 2015). The outcome of the Organification process is the formation of MIT and DIT which help with the formation of T-3 and T-4 hormones, which is then kept with the thyroglobulin in the thyroids follicular lumen. Any disturbance of the regulated mechanism can arise in the pituitary, thyroid or periphery glands and can result in an increase in the transcription in cellular proteins which causes a rise in basal metabolic

The diagnosis of primary hypothyroidism is made by measurement of increased levels of TSH (thyroid stimulating hormone) and decreased levels of TH (thyroid hormone including total T, and both total and free T4)(McCance & Huether, 2014, p. 729). Thyroid disorders are detected by testing TSH, T4, and T3 levels in the blood. A decrease of thyroid hormone causes the pituitary gland to produce more TSH, which increase levels in the bloodstream in an attempt to encourage thyroid hormone production. This rise

We agree that the answer to this question is A: increased TSH. In most patients, hypothyroidism is a result of abnormal development of the thyroid gland (Congenital Hypothyroidism, 2015). This abnormal development poses the largest threat when T4 levels are decreased. Decreased T4 values trigger the pituitary gland to respond by producing thyroid stimulating hormone (TSH). Because the thyroid gland is malformed, the low T4 levels cause the pituitary gland to continually receive signals from the hypothalamus that more TSH needs to be produced. In conclusion, when lab results display a low T4 level and an elevated TSH level, the suspicion of hypothyroidism is confirmed.

The two main hormones secreted by the thyroid gland are tetraiodothyronine (thyroxine or T4) and triiodothyronine (T3). Both hormones have a peptide structure containing iodine (three atoms in T3 and four in T4).These two hormones regulate growth and development as well as metabolism. They both speed up the rate of the body’s metabolic reactions, which

The thyroid is a butterfly shaped gland located in base of the front of your neck, just below the Adams apple. It is responsible for manufacturing several hormones that are essential to maintaining your body natural level of homeostasis. This is probably one of the most vital glands that your body has to offer as it produces two main hormones thyroxine (T4) and triiodothyronine (T3). Thyroid cells once released into the blood stream function to remove all the iodine that comes into the body. These cells are the only cells that are capable of doing so. Thyroid cells merge the iodine collected with the amino acid tyrosine to create T3 and T4. T3 is responsible for most of the body’s biological effects however T3 and T4 once its released into the blood stream they are transported to every are of the body and