April 14, 2014
Path Chart: 40 year old female with suspected myxedematous coma
Etiology/Risk Factors Structural/Physiological Alterations Clinical Manifestations/Complications
Etiology:
• Severe hypothyroidism with low levels of T3 and T4 hormones
Types:
• Primary: impairment of thyroid gland (No TH)
o May be autoimmunity (Hashimoto thyroiditis), surgery (thyroidectomy), Iatrogenic (radioactive iodine ablation), congenital
o Most common
• Secondary: impairment of pituitary gland (no TSH)
• Tertiary: impairment of hypothalamus (no TRH)
• Subclinical: No manifestations
Risk Factors:
• People with history of chronic hypothyroidism
• Iodine deficiency
o Iodine component in creation of thyroid hormones
o Uncommon in U.S. because of fortified foods but common worldwide
• Drugs: propylthiouracel, methimazole, anesthesia, barbituates, beta blockers, diuretics, lithium, narcotics, phenothiazines, phenytoin (alters binding of T4 to TBG), rifampin, tranquilizers
• Females
o 10 times more common in women
o Women are more likely to develop autoimmune diseases
o Patient has higher risk
• 65 years and older
o Overt HPO: 1.7%
o Subclinical HPO: 13.7%
o Patient has lesser risk because <65 yrs
• Postpartum: 6 – 8.8%
• Winter months/ Cold
o 90% occur in winter months
• Infection
• Type 1 Diabetes
o 5-8% risk
o 25% pospartum
• Pulmonary hypertension (>25 mmHg)
o 23 – 49%
• Down syndrome:
o 10-40%: natural elevated level of antithyroid peroxidase antibodies
• Turner Syndrome:
o 36%: natural elevated antithyroid peroxidase antibodies
• First degree relatives with autoimmune hyper/hypothyroid disorder
Prevalance:
• U.S.: 0.3%
• White: 5.1%
• Hispanic: 4.1%
• Black: 1.7%
Incidence...
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Porth, C. (2005). Pathophysiology: concepts of altered health states (8th ed.). Philadelphia: Lippincott Williams & Wilkins.
Over the years, he has collaborated and written academic papers on CTE with other colleagues in the medical community. The goal of the collaborations was to determine and confirm the commonality and epidemiology of the disease, initially the
Today in America thyroid disease is becoming a much larger issue and the worse part of this problem is that many people are not yet diagnosed. This is due to the lack of education and awareness about thyroid disease. There are many different types of diseases but the one that I am passionate about is hypothyroidism. Hypothyroidism, or underactive thyroid is when the thyroid is no longer able to produce triiodothyronine, also known as T3 and thyroxine, also referred to as T4. Some of the symptoms include unexpected weight gain, tiredness, depression, or slow movements and thoughts. Most of the time many people notice the way that their bodies act on what they are feeling to their physicians. Many Americans struggle with this disease that
Follicular cells use iodine from your blood to make thyroid hormones that help regulate a persons’ metabolism. If you have too much of these hormones, it is called hyperthyroidism. Hyperthyroidism symptoms include irregular or rapid heartbeat, trouble sleeping, nervousness, weight loss, and constantly feeling too warm.
The following presentation will help this class in the teaching of a patient with hypothyroidism. The expected outcome of this presentation for the patient will be as follows:
Hyponatremia treatment that occurs too rapidly is associated with the formation of demyelinating lesions in the pons known as CPM. These lesions lead to permanent neurological damage (Gheorghita et. al 2010). Physicians and patients should not fail to treat severe hyponatremia in an effort to avoid CPM development. Failure to treat hyponatremia may lead to severe brain damage, coma, or even death (Schuster et. al 2009 and Gheorghita et. al 2010). Symptoms of CPM have been seen to improve with time which plays the most critical role. Even treating hyponatremia with a hypertonic saline solution still raises the most important risk of developing CPM but a good neurological outcome has been seen in several cases when enough time and one of the above therapies are done.
Although gross medical advancements have allowed the human population to live longer and fuller lives without the threat of death from infectious diseases, it is apparent that we are now dealing with a different phenomenon that may be just as harmful to our health. The impact of psychological, social and environmental factors from our daily lives is having a drastic impression on the mental and physical wellbeing of our society. It has been shown in various studies that psychological and neurological factors influence the immune system and can have an effect on our health (Breedlove, Rosenzweig & Watson, 2010). As we allow various stressors, poisonous substances, unhealthy diets and lack of rest to overwhelm our existence, we are inevitably shortening our life span and killing our bodies.
The third category is clinically silent deterioration. This is often overlooked clinically with sudden unexplained decrease in hematocrit being the only sign.
Do you suffer from a low body temperature, sensitivity to cold that extends to cold hands and feet? Do you frequently experience headaches, insomnia, dry skin, puffy eyes, hair loss, brittle nails and joint aches? If you answered yes, then you my friend, could be suffering from an underactive thyroid. But sadly the symptoms don’t end there. An underactive thyroid may even leave you walking around in a fog, with constipation, a hoarse voice, ringing in the ears; dizziness, low sex drive and the dreaded… weight gain.
The purpose of this paper is to define stress and how it effects the body's physiological systems. This paper will include the normal functions and organs involved in the following five physiological systems, cardiovascular, gastrointestinal, respiratory, immune and musculoskeletal. This paper will also include a description of a chronic illness associated with each physiological system and how the illness is affected by stress.
Porth, C. (2009). Pathophysiology: Concepts of Altered Health States (8th ed.). Philadelphia: Lippincott, Williams & Wilkins.
McCance, K.L. & Huether, S.E. (2010). Pathophysiology: The biological basis for disease in adults and children. (6th ed.) Mosby: Maryland Heights, Missouri. ISBN: 978-0323065849.
is characterized by “deterioration in the level of consciousness, with lethargy, decrease in arousal and headache. The timing of the development of cerebral edema is variable, within most cases occurring 4 to 12 hours after starting treatment. Several case reports showed the presence of cerebral edema before the initiation of therapy. A method of clinical diagnosis based on bedside evaluation of a neurological state in DKA have been developed” (Pandey).
The notion of health is contextual and an interactive, dynamic process between person and environment (Schim et al, 2007). Both wellness and illness are conceptualized by the ‘person’, existing on a continuum across the lifespan (Arnold & Boggs, 2001).
Among these disorders are hypothyroidism and hyperthyroidism. Hypothyroidism is a disorder in which one is diagnosed for having and underactive thyroid. The probability for women over the age of sixty to develop an underactive thyroid is higher than those of other individuals. If left untreated it can potentially lead to obesity, joint pain, heart disease, and other health complications. On the contrary, hyperthyroidism is a disorder in which a person is diagnosed for having an overactive thyroid. This can cause nervousness and anxiety, hyperactivity, unexplained weight loss, and swelling of the thyroid gland which causes a noticeable lump to form on throat (known as a
Uhland, Vicky. “The Picture of Health.” Momentum 6.3 (2013): 42-45. Academic Search Premier. Web. 20 Mar. 2014.