"CASE STUDY #1
Graves disease, as characterized by exophthalmos and stare, was diagnosed in a 51-year-old man. Examination revealed a history of nervousness, palpitations, weight loss, diarrhea, dyspnea on exertion, insomnia, heat intolerance, and fatigue. An ECG showed AF with a ventricular rate of about 180 BPM, which was treated with digoxin and propranolol. A CXR film disclosed cardiomegaly. Thyroid function tests showed T4 and T3 levels to be elevated, and a thyroid scan showed diffuse enlargement of the gland. The patient was treated with radioactive iodine and is now euthyroid. The exophthalmos has not resolved, however.
As you probably know, Graves disease is a thyroid condition. Is it a result of having hypothyroidism or hyperthyroidism? Is this patient "hypo" or "hyper"? How do you substantiate your answer? What is the purpose of the radioactive iodine? Briefly discuss the two heart conditions this patient has. Are they related to the thyroid condition?"