Exophthalmia Case Study Answers

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Clinical Findings
1. The patient’s hands are tremoring. 2. The patient shows moderate enlargement of the thyroid gland. 3. The patient is sweating excessively.

Laboratory Findings
1. The Free T3 and T4 levels are elevated.
2. TSH is lower than normal range which is usually .4 to 4.0 U/ml..
3. Thyroid antibodies (TRAb and TBII) are present.

2. (15 pts.) What is exophthalmia? What are palpitations? What is the cause of each of these symptoms (be specific)? 1. When a patient has eyeballs that are protruding, it is referred to a exophthalmia and it can affect either one or both eyes. It is commonly seen in people with Hyperthyroidism. (Nordqvist, 2017). 2. “A heart palpitation is when someone has a heightened awareness of their heartbeat because it does not feel right. This may be because their heart is pounding too hard, too fast, too slow, or irregularly” (Seymour, 2017). It is often caused by anxiety, illness, physical exercise, or distress. 3. Exophthalmia can be caused by many things, but mainly by Graves Disease or an issue with the thyroid gland. There is usually a carbohydrate buildup in the muscles/ behind the eyes. It can also be caused by other conditions such as blood clotting or an injury to the eye. Palpitations can be caused by anxiety or other emotional issues
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TSH is stimulated by the neurohormones, TRH (thyrotropin-releasing hormone) is secreted by the hypothalamus. The hormone, T3 and T4 are not being secreted at normal levels because the patient is presenting high levels of it. This is due to a failure in the negative-feedback loop; the high concentration of T3 and T4 are not inhibiting the TSH. That is why the autoimmune system for the TSAb is positive. The receptor for the thyroid is malfunction because of the antibody, so the negative feedback part to stop the production of T3 and T4 is not functioning (K. Milas MD.,

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