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Review the four case studies below. Based on each patient’s symptoms, physical exams, and lab results determine which endocrine system disorder each patient is likely to have. The list of possible disorders (with common symptoms and findings) is attached.
For each case study, state what the patient’s disease is, and support your diagnosis with information (i.e., evidence) from the case study. In other words, “Why do you think the patient has the disorder you determined; What is your evidence for your diagnosis?
Include, patient’s endocrine disorder “diagnosed” (in a complete sentence), appropriate evidence from case study included to support diagnosis, and at least 3 sentences for each case study.
Case #1
History
Jill, a 50-year-old woman, presents with enlargement of her left anterior neck. She has noted increased appetite over past month with no weight gain and has had some diarrhea in the past couple of weeks. She recently went to her eye doctor with concern that her eyeballs were “sticking out of her face a bit.” Her eye doctor referred her to her primary care physician.
Physical Exam
She is 5'8" tall and weighs 155 lb.
Heart rate and blood pressure are normal.
Laboratory Results
Lab results show an increase in free thyroxine (T4) and low TSH. Thyroid antibodies present.
What is your diagnosis?
Case #2
History
A 42-year-old man presents with a chief complaint of painful muscle cramps in his neck and legs, and tingling sensation in his hands. He also reports some hair loss from his scalp, which he states causes him anxiety.
Physical Exam
He is 5’10”" tall and weighs 165 lb. The patient’s heart rate and blood pressure are normal. An EKG indicates abnormal heart rhythm.
Laboratory Results
Lab results low blood calcium, and normal TSH.
What is your diagnosis?
Case #3
History
Marie is a 28-year-old woman with recent tiredness and difficulty concentrating had experienced a decline in memory over the last several months. She also noted decreased frequency of bowel movements and an increased tendency to gain weight. She felt chilled without a light sweater, even in warm weather. She stated that her older sister has had similar symptoms over the past few years.
Physical Exam
She is 5'5" tall and weighed 125 lb.
Her pulse rate is below normal, and her blood pressure was 138/88 (slightly elevated).
Case #3 (continued)
Physical Exam
Marie is 5'5" tall and weighs 125 lb.
Her pulse rate is below normal, and her blood pressure is 138/88 (slightly elevated).She has a slightly puffy face, and her eyebrows are sparse, especially at the lateral margins.
The thyroid is firm and with an estimated weight of 25 g (normal 15-20 g).
Laboratory Results
Laboratory testing showed a decreased thyroxine level with a markedly increased TSH.
What is your diagnosis?
Case #4
Jack is a 21-year-old Caucasian male who lives with his parents, reports to your clinic with a chief complaint of gradual onset of weakness and fatigue, and pain in his knees. Jack works at United Parcel Service (UPS) at night while attending the local community college during the day. His work duties require him to lift boxes up to 60 lbs. by himself and he has been struggling to do so in recent months, even becoming dizzy and nearly fainting a few times. He has used almost all of his sick days due to feeling nauseous and vomiting while at work and occasionally before coming to work. He reported a slight decrease in his weight and not being hungry nearly as often. When he does feel like eating he always chooses salty foods. Jack also complains of diarrhea.
Jack states that he doesn’t know why his summer tan has not faded like it usually does (it is now January, and he has not used a tanning bed). He states his parents are worried because he is quick to become irritated with them and rarely comes out of his room when at home.
Lab results: Blood sugar decreased; sodium level decreased. Cortisol levels elevated.
What is your diagnosis?
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