Part I
Note anything unusual about Ellie’s behaviour or appearance
There are two references to shaking hands in the passage. Additionally, she seems to be very thin and have large, perhaps slightly bulging eyes. Behaviourally, she seems stressed and despondent, unable to concentrate or retain information, and and seems to be suffering from insomnia. She then gets a sinus infection, which is perhaps a sign of a compromised immune system.
What do you think might be going on with Ellie that could cause her difficulties? Consider both physical and psychological causes.
Morvan 's syndrome is a rare autoimmune disease, which is characterized by irregular muscle contraction, which explains her hand tremors; insomnia; and a weak immune …show more content…
If Ellie’s thyroid is hyperactive, it is releasing a large amount of thyroid hormone, meaning a large amount of T3 and T4. A large amount of T3 would greatly inhibit the release of TSH by the pituitary gland. This may appear paradoxical, as TSH stimulates the release of thyroid hormones, but in cases of hyperthyroidism, the excessive amounts of T3 and T4 are generally not caused by elevated levels of TSH. This is, unless, the aforementioned negative feedback between TSH and T3 is disrupted, which is quite rare. Therefore, if Ellie has a hyperactive thyroid, the blood tests should show an elevated level of thyroid hormone and a decreased level of TSH. The opposite should be true for hypothyroidism; low thyroid hormone levels would trigger the release of TSH. However, since the hypothyroidism is characterized by low thyroid hormone levels, a simple release of TSH cannot result in an elevation of T3 and T4, otherwise there would be no problem with the thyroid. Subsequently, TSH is continually secreted by the pituitary with no or little effect on the secretion of T3 and T4. Therefore, if Ellie has a hypoactive thyroid, the blood tests should show a decreased level of thyroid hormone and an increased level of …show more content…
Do some research on the average age of onset and any gender differences in Graves’ disease to see if Ellie’s diagnosis is unusual.
Graves’ disease is roughly 7 times more common in females than in males, and, according to the NHS, occur mainly in those aged 30-50. Ellie’s condition is by no means unusual, as she is in the gender naturally predisposed to Graves’ disease, and outside the most common age bracket by a decade.
How are beta-blockers like propranolol helpful as an initial treatment for Graves’ disease? Do they have any effect in reducing thyroid hormone levels, or do the counter the effects of the hormones?
Beta blockers do not have any effect in reducing thyroid hormone levels. Rather, beta blockers counter the symptoms of hyperthyroidism and Graves’ disease. They are a class of drugs which block the receptor sites for adrenaline and norepinephrine, thereby lessening the extent to which the body is affected by the sympathetic nervous system. Excessive T3 and T4 result in an increase in the metabolic rate, as well as symptoms such as nervousness, rapid pulse rate, and shakiness, all of which beta blockers serve to eliminate or lessen. Beta blockers can mediate the negative effects of Graves’ disease until long-term treatment can supplant this temporary
Note anything unusual about Ellie’s behaviour or appearance
There are two references to shaking hands in the passage. Additionally, she seems to be very thin and have large, perhaps slightly bulging eyes. Behaviourally, she seems stressed and despondent, unable to concentrate or retain information, and and seems to be suffering from insomnia. She then gets a sinus infection, which is perhaps a sign of a compromised immune system.
What do you think might be going on with Ellie that could cause her difficulties? Consider both physical and psychological causes.
Morvan 's syndrome is a rare autoimmune disease, which is characterized by irregular muscle contraction, which explains her hand tremors; insomnia; and a weak immune …show more content…
If Ellie’s thyroid is hyperactive, it is releasing a large amount of thyroid hormone, meaning a large amount of T3 and T4. A large amount of T3 would greatly inhibit the release of TSH by the pituitary gland. This may appear paradoxical, as TSH stimulates the release of thyroid hormones, but in cases of hyperthyroidism, the excessive amounts of T3 and T4 are generally not caused by elevated levels of TSH. This is, unless, the aforementioned negative feedback between TSH and T3 is disrupted, which is quite rare. Therefore, if Ellie has a hyperactive thyroid, the blood tests should show an elevated level of thyroid hormone and a decreased level of TSH. The opposite should be true for hypothyroidism; low thyroid hormone levels would trigger the release of TSH. However, since the hypothyroidism is characterized by low thyroid hormone levels, a simple release of TSH cannot result in an elevation of T3 and T4, otherwise there would be no problem with the thyroid. Subsequently, TSH is continually secreted by the pituitary with no or little effect on the secretion of T3 and T4. Therefore, if Ellie has a hypoactive thyroid, the blood tests should show a decreased level of thyroid hormone and an increased level of …show more content…
Do some research on the average age of onset and any gender differences in Graves’ disease to see if Ellie’s diagnosis is unusual.
Graves’ disease is roughly 7 times more common in females than in males, and, according to the NHS, occur mainly in those aged 30-50. Ellie’s condition is by no means unusual, as she is in the gender naturally predisposed to Graves’ disease, and outside the most common age bracket by a decade.
How are beta-blockers like propranolol helpful as an initial treatment for Graves’ disease? Do they have any effect in reducing thyroid hormone levels, or do the counter the effects of the hormones?
Beta blockers do not have any effect in reducing thyroid hormone levels. Rather, beta blockers counter the symptoms of hyperthyroidism and Graves’ disease. They are a class of drugs which block the receptor sites for adrenaline and norepinephrine, thereby lessening the extent to which the body is affected by the sympathetic nervous system. Excessive T3 and T4 result in an increase in the metabolic rate, as well as symptoms such as nervousness, rapid pulse rate, and shakiness, all of which beta blockers serve to eliminate or lessen. Beta blockers can mediate the negative effects of Graves’ disease until long-term treatment can supplant this temporary