Case 1A A 43-year-old woman presents with a 2- to 3-month history of nervousness, increased sweating

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Case 1A

A 43-year-old woman presents with a 2- to 3-month history of nervousness, increased sweating, decreased tolerance to heat, palpitations, fatigue, weight loss with increased appetite, and increased bowel movement frequency. She also has puffiness around her eyes, and she has noted episodes of double vision, also of 2 to 3 months’ duration. She is otherwise healthy, takes no medications, and leads an active working life. This is her first episode of hyperthyroidism.

Palpation of her neck reveals a diffusely enlarged thyroid gland, representing a goiter of 70 to 80 gm. She has a regular pulse of 105 beats/min and typical but minimal eye signs. Serum levels are triiodothyronine, 354 ng/dL (reference range 52-160 ng/dL); thyroxine, 13.9 μg/dL (reference range 5.5-12.3 μg/dL); TSH, <0.05 μU/mL (reference range 0.05-5 μU/mL); and free thyroxine, 2 ng/mL (reference range 0.7-1.8 ng/mL). Questions for Discussion:   What is the significance of the laboratory values?     SCIENCE HEALTH SCIENCE NURSING NUR 1310

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