CLlnlCAL SCLnA8lC lC8 lLA (1P?

8Clu)

A 23 year old woman presenLs wlLh palplLaLlons Cver Lhe pasL 6 monLhs she has reporLed loose
sLools a 43kg welghL loss desplLe a good appeLlLe and food lnLake shaky hands lnLolerance Lo hoL
weaLher and lncreased lrrlLablllLy She appears Lo be anxlous and has a pulse of 119 beaLs per
mlnuLe and a blood pressure of 147/70mmPg Per Lhyrold gland ls dlffusely and symmeLrlcally
enlarged Lo Lwlce Lhe normal slze and lL ls flrm and nonLender a Lhyrold brulL ls audlble She has an
eyelld bag mlld propLosls buL no perlorblLal edema 1he serum LhyroLropln level ls 002 u per ml
(normal range 033 Lo 430) and Lhe level of free Lhyroxlne ls 410 ng per dL (normal range 089 Lo
176)

JhaL ls Lhe dlagnosls? Pow should she be fuLher evaluaLed?

She was offered medlcal LreaLmenL She was noL compllanL and could noL LoleraLe lL

She had surgery (subLoLal LhyroldecLomy) Slx hours afLer surgery she could noL breaLh
(sLrldor) A blood LesL was done She was glven cerLaln drugs Cne monLh laLer
she was feellng qulLe well



























uLA81MLn1 SPA8L ln ulSCuSSlCn

ANA1CM ( S m|n )
1) slLe ln neck
2) relaLlons

nIS1CA1nCLCG ( 1S m|n )
1) gross and mlcroscoplc changes of Crave's dlsease
2) role of anLl1SP recepLor anLlbodles

nSICLCG ( 1S m|n )
1) regulaLlon of Lhyrold gland
2) acLlons of excess Lhyrold hormones

8ICCnLMIS1k ( 1S m|n )
shorL revlew on synLhesls of Lhyrold hormones

nAkMACCLCG ( 20 m|n )
1) LreaLmenL of Crave's dlsease
anLlLhyrold drugs mechanlsm of acLlon doses slde effecLs
beLa blockers
2) LreaLmenL of hypoparaLhyrodlsm
123dlhydroxycholecalclferol 1hydroxycholecalclferol
calclum preparaLlons
3) LreaLmenL of posLoperaLlve hypoLhyroldlsm
LLhyroxlne
IN1LkNAL MLDICINL ( 20 m|n )
1) dlagnosls cllnlcal lab and lmaglng
2) course
3) cholce of LreaLmenL
4) slde effecLs of dlfferenL llnes of LreaLmenL (lncludlng posLoperaLlve hypoparaLhyrodlsm and
hypoLhyroldlsm)

GLNLkAL DISCUSSICN ( 30 m|n )