Pathophysiology

Sean Dille

The Thyroid Gland- Normal Function

The thyroid gland’s main function is to produce hormones such as thyroid hormone and iodine hormones T4 &T3. It maintains homeostasis throughout the body. Thyroid gland is made up of two lobes of squamous epithelial cells called follicle (Marieb, E. N., & Hoehn, K. (2007). Follicle cells store a thyroid globin protein called colloid. Colloid is an amber sticky substance that attaches to the iodine hormones thyroxine binding globulins (TBG). Then T4 and T3 bind to the receptor cells and enter the nucleus (Marieb, E. N., & Hoehn, K. (2007). When the blood levels decrease thyroid hormone send message to release more thyroid stimulating hormone. When this happens thyroid hormone levels increased it inhibits Hypothalamic Adenoypophyseal axis ( Marieb, E. N., & Hoehn, K. (2007). This increases the metabolic demand for the body functions.

The Thyroid Gland- Abnormal Function

Thyrotoxicosis is a classified as over production of thyroid hormone also called hyperthyroidism (McCance, K. L., & Huether, S. E. (2019). The thyroid hormone is controlled by a negative feedback loop the organs affected are hypothalamus, thyroid gland, and pituitary gland (McCance, K. L., & Huether, S. E. (2019). Factors affecting the Grave’s Disease are genetics and environmental factors. The environmental factors are a key role in disease state. This is classified as an autoimmune type II hypersensitivity which affects the lymphocytes and the antibodies against the Thyroid stimulating hormone sites (McCance, K. L., & Huether, S. E. (2019). Which then increase the negative feedback loop to increase hormones then increase the gland and causes hyperplasia to form a goiter (McCance, K. L., & Huether, S. E. (2019). When this happens, it increase all metabolic demand on all body systems and puts the body out of homeostasis.

 

Correct Diagnosis- Graves Disease

The condition of Graves Disease is diagnosed by lab tests and clinical symptoms. The patient will have a positive thyrotropin receptor antibodies test. Also, clinicians may perform an iodine scan of the thyroid gland to look at the gland where the iodine is absorbed (McCance, K. L., & Huether, S. E. (2019). The patient will experience weight loss, heat intolerance, warm moist skin, menstrual irregularities, exophthalmos. Other contributing factors are celiac disease, anxiety. Goiters form by increase of thyroid hormone being produced and correctly stop production when levels normalized (McCance, K. L., & Huether, S. E. (2019). Exophthalmos is caused by T cell secretion and inflammatory cytokines are produced which causes a reaction of the hypertrophy and hyperplasia of fibroblast cells. This makes the fibroblast cells to secrete glycosaminoglycans this causes the swelling of the muscle and connective tissue around the eye socket and the eye to bulge. Hyperthyroidism and hypothyroidism present similar in nature. Labs test will be conducted to confirm the diagnosis of hypothyroidism. The clinical presentation is different from hyperthyroidism such as, constipation, bradycardia, loss of hair, cold intolerance McCance, K. L., & Huether, S. E. (2019).