Part I Initial OfficeVisit You are six months into a yearlo

Part I – Initial OfficeVisit
You are six months into a year-long internship at Dr. Mara Siddiqui’s endocrinology clinic. So far, you’ve had a great
experience with Dr. Siddiqui and you’ve seen patients with a wide range of endocrine issues. Today, you will shadow
Dr. Siddiqui as she examines Angela Barber, a patient who was referred by her primary care physician. While waiting,
you pull up Angela’s information on the computer and you find that she is a 52-year-old African American woman.
Except for not feeling like herself over the last three months, she has no health issues.
Angela arrives at the clinic and you accompany the nurse to the exam room to get Angela’s vitals. Dr. Siddiqui comes
into the exam room and asks Angela what has been bothering her. Angela tells the doctor that she has been cold, tired,
fatigued, and just not feeling up to her normal activities. She has also gained roughly 20 pounds, even though she has
been consciously monitoring her food intake. Angela can’t understand what is wrong—she went through menopause a
year ago but she insists that the way she is feeling is not related to that change; she also has not changed anything else
about her normal routine. Dr. Siddiqui listens to Angela and then examines her ears, eyes, and throat; she also listens
to Angela’s lungs and heart, and palpates her neck and abdomen. All of Angela’s vitals and the outcome of the initial
exam are within normal range. Dr. Siddiqui tells Angela that she suspects a thyroid issue and would like to order some
blood tests.
Angela asks about the thyroid and why it is important. Dr. Siddiqui asks you to help explain this hormone system to
the patient.

11. Dr. Siddiqui asks you what you think is wrong with Angela. What is your diagnosis? (Note: do not simply say hyper-hypothyroidism; that portion of the question was already answered above.)

12. Angela does not have a goiter at the moment. If her condition continues unchecked will she develop one? Why or why not? Make sure you include Angela\'s blood work results to back up your response. (Blood work attached in photo)

Part III Test Results Angela test results come back and Dr. Siddiqui gives you a copy co Look over. I information about Angela to answer the following questions A. Barber-TesL Resulls. Narino Rang 7e 40-12 0.3 NPOand antibodies Normal Nurmal Seram TriiodothyronineiT3y 57 RO-lan ng a 0-12060-RO PotassiunimmoliL

Solution

11: Since she has hypothyroidism (lower level of thyroid hormones) as well as no changes associated with menopause, she could have problem associated with anterior pituitary gland. Anterior pituitary gland secretes TRH which in turn stimulates thyroid gland to release thyroid hormones. The same gland also secretes gonadotropins (LH and FSH) that target the gonads and are responsible for changes associated with menstrual cycle and menopause.