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Cases studies .....for medical student only

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sami220sa

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A 40 years old women who has recently emigrated from Afghanistan to a practice to establish medical care . she complains only of mild fatigue and depression . Physical examination reveals a prominent , symmetrically enlarged thyroid about twice normal size . the remainder of the examination is normal .
Questions :
1- What other features of the history should be elicited ?
2-What is the most likely cause of the patient's thyroid enlargment ? what is the pathogenetic mechanism of goiter formation in this disease ?
3- What laboratory tests should be ordered and why ?

:cool: :love: :clap:
 

leorl

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I'll move this to the allopathic forum, you may get more viewership there.
 

KyGrlDr2B

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Are you wanting us to do your homework for you?? ;) :rolleyes:
 

blueflamer

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why don't you check out these websites for your answer? www.merck.com
www.emedicine.com

also, search for goiter, thyroid, etc. on www.google.com

look at oxford handbook of clinical medicine, robbin's pathologic basis of disease, etc.

i haven't done endocrine yet, but if i had this case i would start to look it up this way... good luck!
 

Airborne

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I'll agree with previous people who have posted replies...

What is YOUR differential diagnosis?

It is a bit easy to post PBL questions without having looked up the pathology, etc yourself, to expect looking well in follow-up sessions.

After YOU have posited something, which you feel is relevant to the case, I'd be more than happy to give input.

SO - Be a first year, and let the ideas flow! This is what medicine is about...

Airborne
 

saori

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It's tricky to answer a question regarding a patient over a bulletin board. I would always rather see the patient myself. As to exams I would order:

CBC
(All Thyroid Hormone Tests)
T4
TSH
T3
FTI
T3U
Thyroid Scan and Radioactive Iodine Uptake Test (*if available at the hospital).

This of course, based on your initial clinical appreciation that this woman has an enlarged thiroid upon physical evaluation...

Good luck!
 

MustafaMond

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The answer is Iodine Deficiency (endemic goiter)
LOL!

Take that **** back to Afghanistan, sami!
 

RedSHIFT

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tell the Afghanistan tribal people to eat some iodinized salt:sleep:....someone needs to open a Denny's in Kabul.
 

dragonark

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always get a pregnancy test before any radioactive uptake scan.
 
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