Thyroid Case: 38-year-old Woman with Insomnia, Anxiety and Hair Loss – Endocrinology | Lecturio
[Music] let's go on to a case a 38 year old woman comes to see you complaining of insomnia frequent stools anxiety hair loss and muscle weakness in her upper and lower extremities on exam her heart rate is 110 beats per minutes and you note that her eyes appear to bulge with visible sclera above and below her iris what would her thyroid labs show so clinically this patient is manifesting significant symptoms and signs of thyroid hormone excess firstly the frequent stools the anxiety and the hair loss muscle weakness when put together really suggests that she has an excess of thyroid hormone when you examine the patient she is tachycardic she has an elevated heart rate and her eyes appear to bulge with sclera visible above the iris this is a whole mark of what we call dis thyroid eye disease where the effect of the excessive thyroid hormone on the eyes most prominent patients have proptosis which is the appearance where the eye appears to bulge in the orbit and the lid of the eye is retracted such a such that you're able to see the sclera above the iris the conclusion of this case is that the patient's clinical presentation is significant for most likely Graves disease we can confirm this diagnosis by checking some labs her TSH will be low and t4 and/or t3 will be elevated which is the classic hallmark or pattern in hyperthyroidism [Music] you