Case Study – Thyroid Gland Puzzle

Case Study – Thyroid Gland Puzzle

Thyroid Function and Hormones

The thyroid gland is an essential endocrine organ situated in the neck and synthesizes hormones controlling metabolism, energy production, and general development. Thyroxine (T4) and triiodothyronine (T3) are the major hormones produced by the thyroid gland. These hormones are significant in controlling the metabolism rate, heart rate, digestive system, muscle movements, brain formation, and bone health (Shahid & Sharma, 2023). They do this by regulating the rate of cellular activities throughout the body to match the body’s energy utilization and production.

Goiter Definition

A goiter refers to an enlargement of the thyroid gland beyond its normal size (Can & Rehman, 2021). It can be caused by iodine deficiencies, autoimmune disorders, and nodular thyroid diseases. The enlargement can be diffuse, where the entire gland is affected, or nodular, where one or more lumps are present. Goiters may be related to hyperthyroidism or hypothyroidism, or they can be non-toxic, meaning they do not affect thyroid hormone levels.

Hyperthyroidism and Hypothyroidism with Goiter

Hyperthyroidism and hypothyroidism can cause a goiter due to their distinct pathophysiological processes. In hyperthyroidism, conditions like Graves’ disease make the gland function more than it should, hence causing the gland to swell. In hypothyroidism, iodine deficiency or Hashimoto’s thyroiditis reduces the secretion of thyroid hormones, causing the gland to grow in size as it tries to secrete more hormones (Shahid & Sharma, 2023). Therefore, a goiter is not unique to any particular thyroid disorder.

Diagnosis: Hyperthyroidism

After evaluating the signs and symptoms presented by the patient, hyperthyroidism is more likely a diagnosis. Besides, exophthalmos, increased energy levels, less fatigue, intolerance to heat, and having a neck nodule are some of the symptoms of hyperthyroidism. These symptoms can readily be associated with hyperthyroidism.

Suspected Graves’ Disease

According to Butt and Patel (2020), the most significant indicator suggesting Graves’ disease is exophthalmos. This is when the eyes protrude; it is common in Graves’ disease, an ailment that occurs when the immune system attacks the thyroid gland, making it produce extra hormones. This symptom, along with other signs of hyperthyroidism, prompts Graves’ disease as a potential condition affecting the patient.

References

Butt, S., & Patel, B. C. (2020). Exophthalmos. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559323/

Can, A. S., & Rehman, A. (2021). Goiter. PubMed; StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/32965832/

Shahid, M. A., & Sharma, S. (2023, June 5). Physiology, Thyroid Hormone. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK500006/

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Scenario
Thyroid gland puzzle

A patient has checked into the ER complaining of having blurry and sometimes double vision. She’s also worried about a lump starting to develop in her throat. When you bring her into triage, you quickly note exophthalmos and the lump. When taking her history, she notes that she has always been remarkably healthy and full of energy. She even brags that she doesn’t need as much sleep. She also complains that it’s warm in your usually cold triage room.

Case Study – Thyroid Gland Puzzle

Instructions
Answer the following questions and save your responses in a Microsoft Word document. Provide a scholarly resource in APA format to support your answers.

What does the thyroid and its associated hormones do?
What is a goiter?
There are cases when both Hyperthyroidism and Hypothyroidism could present with a goiter. Why?
Do you believe that she is presenting with hyperthyroidism or hypothyroidism? Why?
You suspect Grave’s disease. What sign made you jump to this conclusion?