Patho 9

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1 PATHOPHYSIOLOGY Student’s Name University Affiliation Course Professor’s Name Date

2 Case One The Thyroid Issue Identified in The Patient is Centered on The Provided Laboratory Results Hypothyroidism is a thyroid disorder that a 50-year-old woman could be suffering from as per given laboratory test results. Hypothyroidism is an illness related to the thyroid's inability to produce enough thyroid hormones in the body and negatively affects other levels of the body's mechanism (Chiovato et al, 2019). It is important to evaluate the spectrum of T4 levels while dealing with thyroid hormone releases and production, with a little buildup of T4 thyroid hormone normally confirming a disorder linked to hypothyroidism. The reference range for a person with a normally functioning thyroid hormone is between 4.0 to 11mcg/dL. T4 levels less than 4 indicate hypothyroidism disorder. Also, the elevated patient's TSH of 30 mU/L, greater than 4.0 Mu/L is a sign of hypothyroidism illness. Miss Jefferson Had the Problem of Failing to Mention the Symptoms of Her Unusual Thyroid Disease. If False, Then Hypothyroidism illness might sometime not indicate any major symptoms. The clinical manifestations of hypothyroidism rely on the severity of the disorder. The symptoms tend to occur gradually, normally over many years (Peeters & Brito, 2020). Initially, the patient may hardly notice symptoms of hypothyroidism, like constipation, fatigue, and weight gain. Although as the metabolism continues to slow, the patient can experience more obvious complications. In this case, no important complaints were indicated in the health facility for the patient. In certain conditions, lack of symptoms is a typical sign of a form of thyroid illness. In regard to the patient's report, she has not complained of any clinical manifestations, implying that her hypothyroidism disorder is in its early stages of development.

3 What Is Most Possibly Causing Ms. Jefferson's Thyroid Illness? The patient's thyroid disorder is likely from chronic autoimmune thyroiditis, called Hashimoto thyroiditis, which makes the immune system produce antibodies that attack and destroy the thyroid gland leading to hypothyroidism. The numerous quantities of white blood cells, which constitute the immune system, accumulation in the thyroid. Therefore, the thyroid gets attacked reducing its ability to produce enough thyroid hormones, which controls how a person's body uses energy, hence they interfere with almost every organ in the body. The common manifestation of Hashimoto thyroiditis includes weigh gain and fatigue, although the symptoms may not appear at its initial stage (Kostoglou-Athanassiou et al, 2022). The Patient Inquired About the Next Hospital Visit for The Thyroid Disorder Examination. The Appropriate Response. Healthcare professionals should always schedule patients with the next appointment for follow-up in the event of chronic ailments. The 50-year-old patient is concerned with the next appointment because she needs to be guaranteed that her illness receives appropriate and comprehensive treatment that conforms to the required medical standards. The correct answer to Ms. Jefferson is to have hospital visits yearly, normally referred to as annual medical check-ups. However, once an illness impacts thyroid levels have been established, therapy should be commenced immediately to put the hormones back to normal (Hegedüs et al, 2022). Six weeks after starting therapy, an individual with damaged thyroid hormones need to be evaluated, to ensure hormones are functioning as expected. Thyroid Disorder Forecasted Symptoms in Ms. Jefferson Various clinical manifestations might be noticeable in individuals with varied conditions that are not getting sufficient thyroid-stimulating hormone. Except for laboratory test results, the

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4 50-year-old patient has not indicated any important signs and symptoms during her hospital visit. The most important signs and symptoms to watch out for in this thyroid illness includes excess weight gain, fatigue, intolerance to cold, and diarrhea (Perros et al, 2021). Although the patient has not complained of any mentioned clinical manifestations, they are likely to occur and, it is important for the patient to immediately report any signs and symptoms to the healthcare professional that might be associated with hypothyroidism for appropriate medical intervention. Case 2 The Patient's absence of Glycemic Control's Most Probable Reason The case presents a 50-year-old woman with diabetes mellitus condition with problems controlling her sugar levels in the past 14 days. In regard to the patient's case, the key factor in the diabetic condition is glucose depletion. The use of prednisone in asthmatic management is the most likely aspect of the patient's inability to control her blood sugar levels. Prednisone is classified under corticosteroids, and its usage can lead to reduced insulin sensitivity and elevated glucose levels in the bloodstream (Price et al, 2020). The increase in high blood sugar levels due to diabetic illness, is the body's failure to correctly turn sugars into energy. A Selection of the Most Vital Facts About Glucocorticoid Treatment Should Be Obtained from The Patient's Main Events . Patient education is one of the most significant actions that healthcare professionals should embrace while on a treatment plan with their patients. Informing the patients on the appropriate actions to undertake concerning the prescribed medication must be part of the interaction between the medical provider and the patient in the entire therapy (van der Kruk et al, 2022). In an event where a sign of an infection is noted, the patient should reach out to the

5 healthcare professional for proper assistance. More so, the patient is likely to experience side effects due to the use of glucocorticoids like coldness, vision, agitation, and muscle weakness. If any worrying impacts are noticed, they should be quickly reported to the healthcare professional with immediate effect. The Possible Endocrine Illness the Patient Is at Risk For The patient is at high risk of acquiring Cushing syndrome which develops if a body generates excessive hormone cortisol for a long time. Continuous exposure to increased cortisol levels can lead to the development of noncancerous pituitary gland lumps and the activation of the adrenal cortex to form more cortisol, which results in Cushing syndrome (Valassi, 2022). In regards to the patient's medical history, the use of prednisone medication for asthma therapy has enhanced the probability of getting Cushing syndrome. The healthcare professional need to help the patient to avoid developing the endocrine condition by recommending an alternative mode of therapy. Serious Loss of Glucose Mechanism Has Been Seen in The Patient, Requiring Actions to Keep Glucose Levels Under Control. The administration of insulin will be the major treatment as per the required sliding scale, with the first dose determined by blood sugar levels. The 50-year-old patient has been indicated to be on metformin medication and has been established to be suffering from diabetes type 2, function reduced insulin performance can be treated with the use of effective therapy called insulin administration. Since insulin is needed by the body to help in the conversion of blood glucose to energy, the patient cannot be able to manage their blood sugars solely on metformin medication (Hirsch et al, 2020). To obtain satisfactory results from the medication being used, Patient education should be included

6 References Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in context: where we’ve been and where we’re going. Advances in therapy , 36 , 47-58. Hegedüs, L., Bianco, A. C., Jonklaas, J., Pearce, S. H., Weetman, A. P., & Perros, P. (2022). Primary hypothyroidism and quality of life. Nature Reviews Endocrinology , 18 (4), 230- 242. Hirsch, I. B., Juneja, R., Beals, J. M., Antalis, C. J., & Wright Jr, E. E. (2020). The evolution of insulin and how it informs therapy and treatment choices. Endocrine reviews , 41 (5), 733- 755. https://doi.org/10.1210/endrev/bnaa015 Kostoglou-Athanassiou, I., Athanassiou, L., & Athanassiou, P. (2022). Autoimmune Hashimoto’s Thyroiditis and Hypothyroidism: Novel Aspects. In Hypothyroidism-New Aspects of an Old Disease . IntechOpen. Peeters, R. P., & Brito, J. P. (2020). Subclinical hypothyroidism: to treat or not to treat?. European journal of endocrinology , 183 (6), D15-D24. https://doi.org/10.1530/EJE-20- 0621 Perros, P., Van Der Feltz‐Cornelis, C., Papini, E., Nagy, E. V., Weetman, A. P., & Hegedüs, L. (2021). The enigma of persistent symptoms in hypothyroid patients treated with levothyroxine: a narrative review. Clinical endocrinology . https://doi.org/10.1111/cen.14473 Price, D., Castro, M., Bourdin, A., Fucile, S., & Altman, P. (2020). Short-course systemic corticosteroids in asthma: striking the balance between efficacy and safety. European Respiratory Review , 29 (155).doi: 10.1183/16000617.0151-2019

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7 Valassi, E. (2022). Clinical presentation and etiology of Cushing's syndrome: Data from ERCUSYN. Journal of Neuroendocrinology , 34 (8), e13114. https://doi.org/10.1111/jne.13114 van der Kruk, S. R., Zielinski, R., MacDougall, H., Hughes-Barton, D., & Gunn, K. M. (2022). Virtual reality as a patient education tool in healthcare: A scoping review. Patient Education and Counseling . https://doi.org/10.1016/j.pec.2022.02.005

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