Grave’s Disease.
Number 1 post: AB
A 35-year-old female presents to the clinic with bulging eyes, hand tremors and unexplained weight loss. The final diagnosis is Grave’s Disease.
1. Compare and contrast Grave’s Disease and Hashimoto’s Disease.
Grave’s disease and Hashimoto’s disease are similar in the fact that they are both auto immune disease and that they affect the thyroid gland (Mincer & Jialal, 2021). However, one causes an increase in hormone production while the other causes a decrease in hormone production. The most common caise of hyperthyroid is Grave’s disease. In Grave’s disease, the body’s immune system over produces an antibody called the thyroid stimulating immunoglobulin (TSAb) which along with thyroid stimulating hormone binds at the thyroid which cause an increase production of hormones and a growth of the thyroid (Kahaly, 2020). In Grave’s disease triiodothyronine (T3) and thyroxine (T4) are elevated. The most common cause of hypothyroidism in the United States is Hashimoto’s disease. In Hashimoto’s disease, the immune system attacks the thyroid organ directly (Mincer & Jialal, 2021). This abnormal immune response causes the death of thyroid cells and a diminishing of the thyroid size. The production of T3 and T4 steadily decreases with the progression of this disease.
2. Would you expect this patient’s TSH, T3 and T4 to be high or low? Explain your reasoning.
With the diagnosis of Grave’s disease, this patient has hyperthyroidism. The hormones T3 and T4 are produced by the thyroid and therefore will be elevated with Grave’s disease. Thyroid stimulating hormone (TSH) with the help of an over produced TSAb are used up by stimulating the thyroid. Consequently, TSH will be low in this patient’s blood analysis.
3. Discuss the significance of Hürthle cells in thyroid disease.
When diagnosing an individual with Grave’s disease the provider needs to distinguish this type of hyperthyroidism from other ones. One test that could be performed as part of the differential process is a thyroid biopsy (). If the biopsy identifies the presence of Hurthle cells, then a thyroid carcinoma is the more likely explanation of hyperthyroidism (Kure & Ohashi, 2020).
Number 2 post: RB
A 30 year old male presents with acute trauma. The final diagnosis is DIC.
Discuss the clotting mechanism.
What do prolonged PT and aPTT tests evaluate?
Fibrin degradation and split products are common to DIC patients. Why?
Identify two additional conditions that can initiate DIC and how?
The functioning of the human body is highly dependent on the flow of blood. Consequently, the flow of blood via blood vessels conveys the required oxygen and nutrients to various body cells. To ensure the continued functionality of blood vessels in the event of an injury, the process of blood clotting aids with the repairing of those vessels.
Blood Clotting Process
Blood clotting involves the process where the body is safeguarded from excessive blood loss during an injury. Essentially, the mechanism is entirely triggered by, for instance, an injury in the lining of the blood vessels (Laguipo, 2021). During such a scenario, the clotting process is entirely activated through the formation of a plug by platelets on the affected section of the blood vessel (Laguipo, 2021). The mechanism is typically supported by clotting factors, among them prothrombin, fibrinogen and ionized calcium. Hence, it ensures there is less blood loss in an injury.
What Prolonged PT and PTT Tests Evaluate
PT and PTT tests are extensively conducted with the aim of assessing the hemostatic system for numerous reasons. For instance, the tests could be carried out to ascertain the causes of prolonged clotting times while at the same time excluding other significant bleeding disorders (Laguipo, 2021). Thus, the mentioned tests play a crucial role in measuring the duration of clotting to take place whenever reagents are added to the plasma.
The Reason why Fibrin Degradation and Split Products are Common to DIC Patients
Fibrin degradation is expected among DIC patients since the condition leads to excessive clotting of blood. As a result, high levels of blood clots reduce the rate of blood flow, thus blocking blood from reaching the body’s organs (Luo, 2018). When the mentioned condition advances, clotting factors, platelets and other substances contained in the blood responsible for clot formation reduce because with time, they are used up. Hence, this results in the commencement of excessive bleeding among the affected patients.
Additional Conditions that can Initiate DIC
DIC, as highlighted previously, is a condition that contributes to excessive bleeding. As such, there are other factors that could initiate the condition, among them liver disease and leukemia. Therefore, it is always significant to evaluate the existence of other health conditions.
Overall, blood circulation plays a significant role in the body. Contrarily, cases of excessive bleeding should be addressed speedily to avert fatalities. In short, several tests should be utilized to assess a clotting disorder to ensure the body is functioning well.
