Endocrine System


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S14_F1.jpg"}},{"insert":"\n\n"},{"insert":"You\u0027re done filling out your charts and are ready to leave the office.\n\nIt\u0027s definitely been a long day. You find yourself actually looking forward to that microwaved TV dinner.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S14_F2.jpg"}},{"insert":"\n\n"},{"insert":"Just as you walk out of the door, the nurse calls regarding one of your patients.\n\n\u0022Damn, I jinxed it\u0022, you mutter to yourself, walking hurriedly towards Mr. Mehta\u0027s room, while trying to recall his history.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S14_F3.jpg"}},{"insert":"\n\n"},{"insert":"Mr. Mehta is a 40-year-old X-ray technician.\n\nHe came to your clinic around three weeks ago, complaining of a lump in his neck, a weight loss of five kilograms over three months, and excessive sweating and heat intolerance, all of which suggested at thyrotoxicosis.\n\nYou recall that there were no obstructive symptoms at the time. Prior to this, he was in perfect health.\n"}]}


{"ops":[{"insert":"At his first visit you identified an enlarged thyroid with a dominant nodule in the left lobe.\n\nUltrasonography confirmed a nodular goiter with a dominant nodule, while cytology ruled out carcinoma.\n\nHis thyroid stimulating hormone (TSH) levels were suppressed and both free T3 and T4 were elevated.\n\nIn search of \u0022a permanent solution\u0022 to his condition, he opted for surgery after being offered all the available options. He was not keen on long-term medications.\n\nMr. Mehta was scheduled for surgery this morning and was prescribed iodine to correct his hyperthyroidism and prevent intra-operative complications.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S14_F5.jpg"}},{"insert":"\n\n"},{"insert":"Earlier today, you performed a near-total thyroidectomy on Mr. Mehta.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S14_F6.jpg"}},{"insert":"\n\n"},{"insert":"You reach his room and quickly begin examining him. It doesn\u0027t take you very long to realize that something is amiss.\n\nMr. Mehta is agitated and confused. His temperature is 103\u02daF (39.4\u02daC). His pulse and blood pressure are 140 bpm and 120\/80 mmHg respectively.\n\nYou notice that he does not appear to be dyspneic and that there is no swelling of the neck. His oxygen saturation is 98% on room air.\n"}]}