Question

A 30-year-old male demonstrated a subtle onset of the following symptoms: dull facial expression; droopy eyelids; puffiness of the face and periorbital swelling; sparse, dry hair; dry, scaly skin; evidence of intellectual impairment; lethargy; a change of personality; bradycardia (60 b/min) low range of normal; a blood pressure of 90/70 low BP; anemia low iron – cant transport O through body very well(hematocrit 27); enlarged heart (upon radiological exam); constipation, and hypothermia. Plasma concentrations of total and free T4 and T3 follow:

Radioimmunoassay (RIA) of peripheral blood indicated elevated TSH levels. A TSH stimulation test did not increase the output of thyroid hormones from the thyroid gland.

a. What endocrine organ is involved here?
b. Is this a primary or secondary disorder? Why? (Is a TSH or TRH determination necessary for your diagnosis?)
c. Describe the feedback loop involved, indicating if there is an increased or decreased TSH level.
d. List several defects that could cause these symptoms.
e. Would you expect to find a palpable goiter? Explain your answer.
f. Describe a suitable treatment for this individual.

Answer 1

The endocrine organ involved in this case is the thyroid gland. The patient presents symptoms of hypothyroidism, a primary disorder characterized by insufficient production of thyroid hormones. Treatment options include thyroid hormone replacement therapy.

Step-by-step explanation:

The endocrine organ involved in this case is the thyroid gland. The symptoms described, such as dull facial expression, droopy eyelids, dry hair and skin, and enlarged heart, are indicative of hypothyroidism - a condition where the thyroid gland produces insufficient amounts of thyroid hormones.

This is a primary disorder because the problem originates within the thyroid gland itself. The elevated levels of TSH indicate negative feedback within the hypothalamic-pituitary-thyroid axis, trying to stimulate the thyroid gland to produce more thyroid hormones to compensate for the deficiency.

Several defects that could cause these symptoms include thyroid gland dysfunction or failure, pituitary or hypothalamic dysfunction, and iodine deficiency. These can disrupt the production or release of thyroid hormones, leading to hypothyroidism.

In this individual, you would not expect to find a palpable goiter. A goiter is a visible enlargement of the thyroid gland, commonly associated with iodine deficiency or hyperthyroidism. However, in this case, the low levels of thyroid hormones indicate a lack of thyroid gland activity, rather than excessive activity.

A suitable treatment for this individual would be thyroid hormone replacement therapy. This involves taking synthetic thyroid hormones, usually in the form of levothyroxine, to restore the levels of T3 and T4 in the body and alleviate the symptoms of hypothyroidism.

Answer 2

1. Thyroid gland is the endocrine gland that is involved here.

2. TSH stimulation test did not show an increase in the output of thyroid hormones secreted from thyroid glands which makes it a primary disorder. The determination of TSH or TRH gives an idea about hypothyroidism if it is due to feedback inhibition of the pituitary or absence of TSH hormone from the pituitary, however, Circulating levels of TRH not necessary.

3. The feedback loop involves the following:

TRH hormone secreted from the hypothalamus triggers the anterior pituitary to secret TSH that in turn triggers the relapsing of the T3 and T4 levels by the thyroid glands. If there is a low level of T3 and T4 hormones then negative feedback takes place and increases the TSH output.

4. symptoms:

Not able to uptake the iodide into the cells of the thyroid gland

Defects in the conversion of iodide to iodine

tyrosine molecule iodization

secretion of the hormones from the Tg molecules

Less TSH receptors on the gland.

5. The chronic TSH stimulation due to negative feedback may cause hypertrophy of the gland, results in goiter formation.

6. synthetic hormone therapy is known as Synthroid such asT4 (L-thyroxine).