Questions to prepare for classes and examination
• Synthesis and control of secretion of thyroid hormones. Physiological effects of thyroid hormones.
• Hypothyroidism: types, causes, mechanisms of development and clinical manifestations. Common hypothyroid states: myxedema, cretinism, endemic goiter.
• Hyperthyroidism: types, causes, mechanisms of development and clinical manifestations.
• Pathogenesis and manifestations of Graves' disease, Hashimoto's thyroiditis, iod-basedow and Wolf-Chaikoff's phenomena.
• Thyrotoxic and myxedema coma.
• Typical disorders of the parathyroid gland. Causes and manifestations of hypoand hyperparathyroid states.
N 133
A 30-year-old female patient L. complains of fatigability, muscle weakness, difficulty in falling asleep, palpitations, excessive sweating and heat intolerance, frequent stool, and significant weight loss. Three years ago she experienced a severe viral infection, and since that time suffered from episodes of unexplained pain in the anterior neck in the region of the thyroid gland. She ignored these symptoms and did not visit her doctor. On examination: the thyroid gland is slightly increased, indurated, nontender on palpation; heart rate is 98 beats per minute, blood pressure 150/80 mm Hg; signs of the left heart ventricle hypertrophy; the skin feels warm and moist; exophthalmos is evident. When the patient is instructed to look at the finger moving downwards there is a moment before the upper lid catches up with the globe (lid lag). Concentration of thyrotropin in the patient's blood serum is decreased, while the content of IgG is increased.
Questions
• What form of pathology does the patient suffer from? Substantiate your answer.