Question

Name Case Study: Endocrine system A 50 year old male had a total thyroidectomy followed by thyroid hormone-replacement therapy. 36 hours later he developed muscle cramps in his arms and hands and mild tetany The following tests were performed urinary calcium urine phosphorous 20 mg/dL (normal: 5 to 15 mg/dl) 0.1 g/day (normal: 0.075 to 1.0 mg/day) 6.0 mg/dL (normal is 8.5 - 10.5 mg/dL) plasma calcium plasma phosphorous 5.0 mg/dL (2.7-4.5 mg/dL) Calcium gluconate and vitamin D (calcitriol) were given orally each day and the tetany and muscle spasm were alleviated 1) What endocrine disorder is present in this person? Explain your answer using the data provided 2) What is the purpose of the administration of vitamin D with the calcium? 3) What are some signs and symptoms a patient might experience who is suffering from this disorder? 4) Draw or describe the negative feedback pathway for the main hormone involved

Answer 1

1) Patient is suffering from hypothyroidism.

Hypothyroidism occurs due to removal of thyroid gland due to which thyroid hormones are reduced in amount in body, due to which following symptoms are presented by patient.

2) Vitamin D is essential for calcium absorption from small intestine and kidneys, it increases calcium absorption.

3) signs and symptoms are -

Fatigue

Cold sensitivity

Weight gain

Constipation

Muscle cramps

Dry skin

4)

calcitonin -

ng Hypothalamus releases (-) TRH Anterior Pituitary gland- releases (-) TSH Thyroid gland releases ТЗ, Т4 (-) feedback

Increased plasma calcitonin ---> stimulates thyroid C cell ---> calcitonin ---> decreases plasma calcium levels --> inhibits thyroid c cells.