Introduction
The patient in our case is Sandra Bullock, a middle-aged woman. Sandra Bullock has a modern lifestyle and has no time for proper exercise and a healthy diet. In addition, Sandra Bullock has five children. In this scenario, Sandra has come to the general practitioner with sudden changes concerning palpitations, tremors, and tiredness. Additionally, Sandra always feels hot even when others are feeling cold, and her weight has reduced by 5 kg over the past two weeks without any effort or exercise. The report on the pathophysiology assignment concerns the identification of the underlying endocrine condition of the patient based on the blood test. Also, the report analyses the clinical features and conditions experienced by Sandra presently. This report presents the patient’s interpreted blood test results, the identification of risk factors, along with the pathophysiology condition of the patient. Lastly, the report also describes the medication prescribed to Sandra by the endocrinologist.
Part 1 Questions
Identification of the underlying conditions
The endocrine condition in human bodies results from the endocrine system’s malfunction during the secretion of hormones (Zhang and Xiao 2022). The three core reasons for endocrine conditions are overproduction of certain hormones, the inability of the proper functional activities, and underproduction of hormones for example thyroid (Darbre, 2018). In our scenario, the patient has been suffering from type 2 diabetes and rheumatoid arthritis for several years. Unexplained and unaccounted-for endless energy and weight loss are the first symptoms of hyperthyroidism that seems good in the beginning in most cases. It is worth mentioning that hyperthyroidism is one of the leading underdiagnosed endocrine conditions that remain unchecked in most cases. In the case of Sandra Bullock, this condition can occur with major complex conditions that can create serious complications in the later stages of life in the form of eyesight and hypertension problems. From Sandra’s blood test, the report indicates the underlying critical condition of Thyroxine (T4) and Triiodothyronine (T3) as being higher than the normal required level. The primary function of the thyroid hormone is to control body weight, temperature, heart rate, breathing, the nervous system, and metabolism (Vinay et al., 2018). In the case of Sandra, the body temperature, heart rate, and breathing rate are within the required range; they are not normal. The patient displays the underlying complexities related to hyperthyroidism with anxiety, excessive sweating, hand tremors, and nervousness.
Interpretation of Sandra’s blood test and clinical features
The first issue on the blood test is haemoglobin. The level of haemoglobin in the patient’s body is 125 g/L. It is worth noting that a woman’s normal range for haemoglobin is 120-150 g/L (Sunuwar et al., 2019). In our case, Sandra’s haemoglobin is within the normal range. In addition, the platelet count, neutrophil, and white cell count are within the normal range in the case of our patient.
Conversely, the patient is facing issues concerning hyperthyroidism with palpitation and irregular heartbeat, where Sandra has high Thyroxine (T4) and Triiodothyronine (T3) and low thyroid stimulating hormone (TSH). At the same moment, Sandra’s body has developed a thyroid stimulating hormone-Receptor antibody that indicates her critical condition regarding endocrine that needs proper treatment along with identification of the reason for such a fact. For instance, Sandra’s hyperthyroidism may happen due to Grave’s disease, such as type 2 diabetes. Type 2 diabetic condition is the one common reason for the occurrence of hyperthyroidism as the individual undergoes through secretion of excessive thyroid hormone as a result of autoimmune disorder (Kalra et al., 2019).
Another reason for the occurrence of hyperthyroidism is thyroiditis. This occurs when the inflammation of the thyroid occurs in three patterns postpartum, silent, and subacute (Subekti et al., 2018). For instance, silent thyroiditis happens as a result of a possible enlarged thyroid that is a variant form an autoimmune condition, and this condition is painless for the patients. Conversely, postpartum cases happen after giving birth to children; women go through thyroiditis in this period. Another form of thyroiditis is subacute, which occurs as a result of bacteria and viruses with enlarged thyroid that is also painful for the patient (Patrizio et al., 2021). In the case of Sandra, an overactive thyroid nodule is a reason for the ramp-up production of thyroid hormone as a result of lumps on the thyroid gland.
The risk factors
The first risk factor in the case of our patient development of hyperthyroidism with these blood test results includes having a family history of thyroid disease as her mother suffers from Hashimoto thyroiditis. In this case, the genetic factor is a critical risk factor in developing hyperthyroidism (Pereira and Lim, 2021). The second risk factor is blood glucose. The blood glucose level in this case of Sandra is not normal. In the scenarios of our patient, this factor has made her exposed to the condition of hyperthyroidism. Another risk factor is gender. Female patients, in most cases women, develop such issues regarding thyroid compared to men. The last risk factor is lifestyle. Not having proper dietary control, smoking behaviour, and taking medicines on time are crucial risk factors for the occurrence of the disease (Antonelli et al., 2020).
Pathophysiology of specific conditions Sandra is suffering from
Our patient is suffering from hyperthyroidism, impacting Sandra’s daily life and her ill health conditions. In the scenario of hyperthyroidism, the secretion of triiodothyronine increases compared to thyroxine in the body, while thyroxine converts into triiodothyronine in peripheral tissues. In our case, the blood test report of the patient has identified a higher level of triiodothyronine. It is worth mentioning that hyperthyroidism occurs due to too much production of thyroxine hormone. In most cases, this condition comes with symptoms such as unintentional weight loss along with irregular heartbeat. Sandra displays all these symptoms, and the significant tiredness is another symptom that was witnessed in the case of our patient. The endocrine system secretes an accurate amount of each hormone to complete distinct processes of the human body. Hormones are crucial chemical messengers of the human body that impact appetite, weight, and mood with other aspects of the body and mind (Tsai and Leung 2021).
Additionally, the fast-paced lifestyle in these modern days sets in hormonal imbalances. In addition, while some hormones decline as a result of age, some individuals experience key endocrine conditions dramatically compared to others. Having that mentioned, balancing hormones is an important aspect of controlling endocrine in the patient.
The implications of the condition
The patient in our case is faced with complications regarding hyperthyroidism, among them heart palpitations and irregular heartbeat, hand tremors and shakiness, excessive sweating and heart intolerance, and increased blood sugar and eye problem. With regard to Sandra’s case, the patient has an issue concerning type 2 diabetes.
The first issue is an irregular heartbeat and heart palpitations. The thyroid hormones of the patient have directly impacted the functioning of the heart, which has led to an increase in the irregularity of the heartbeat along with palpitations. This witnessed abnormal rhythm requires to be taken seriously to make Sandra free from the situation. Irregular heartbeat and palpitations indicate heart problems (Isakadze and Martin 2020). Another issue is excessive tiredness and sweating. The patient has been experiencing tiredness for a few days, which is a common complexity regarding health. Another issue is an eye problem in the case of the patient as she realized “a bit puffy” eyelids, and her friends addressed that her eyes look as if Sandra is staring at them. The third issue is shaking and tremors, which are identified in the case of the patient. The patient witnessed sudden changes in her health that have impacted her normal behaviour. For instance, Sandra has always faced tremors and shakiness in her hands. The last issue with Sandra is heat intolerance.
Question two
The four risk factors in the case of Sandra Bullock are high blood pressure, overweight, age and inactivity.
High blood pressure
Sandra has pressure over 140/90, which is higher. This has led to an increased risk of type 2 diabetes, and this is a complex risk factor for the occurrence of HbA1c and BGL in our case.
Overweight
From the report, the patient is near obesity level, and Sandra is overweight.
Age
Current days, type 2 diabetes is also noticed in younger adults, children, and adolescents. However, the risk of HbA1c and BGL increases with age (Nagashima et al., 2022). The patient gained weight with her aging along with losing muscle mass because she does not engage in physical exercise. In addition, Sandra does eat healthy food and does not adhere to her medication timetable.
Inactivity
The major risk factor for the development of type 2 diabetes in Sandra’s case is lack of exercise or physical activity. Physical activity is important in the management of weight. Being obese or overweight makes it hard to manage Type 2 diabetes.
Medications prescribed.
Sitagliptin (Januvia) 50 mg
The mentioned medication will assist in the management of type 2 diabetes mellitus. However, this medication should be used by the patient while she engages in physical exercise and a healthy diet. In addition, Sandra should make changes to her lifestyle. Sandra is a mother and smokes daily. With this, Sandra needs to avoid a lifestyle that increases her heartbeat rate. The most important reason for prescribing this medication to the patient is that the other medication the patient takes cannot work effectively without exercise to control BGL. Sitagliptin medication can be taken after a meal or on an empty stomach. The side effects of this medication include headache, upper respiratory tract infection, nasopharyngitis, and hypoglycaemia (Sangle et al., 2018).
Carbimazole 5 mg
This is an effective anti-thyroid medication that assists patients with an overactive thyroid gland. This medication should be taken by patients suffering from severe liver or blood disorders (Hossain, 2019).
Five complications
There are various complications that Sandra may face if she fails to engage in physical activity, does not change her lifestyle and health, and fails to take prescribed medication on time. These complications include clouding of the eye’s cataract, nerve damage, kidney failure, cardiovascular disease, and damage to the retina’s blood vessels that lead to blindness.
Preventive measures
- Losing weight
Increased weight is the most critical issue of concern to the patient when it comes to fighting the problem. With this, Sandra is required to engage in exercise.
- Carbs careful selection
A healthy diet is a major concern to assist the patient manages diabetes efficiently. Healthy eating and taking medicines on time can assist the patient in managing type 2 diabetes (Utami and Findyartini 2018). The main reason for prioritizing these measures is that the patient does not take a healthy diet and also does adhere to her medication schedule.
- Managing Stress
. Stress can significantly affect the ability of a person to manage stress.
- Getting adequate sleep
Rest and sleep are important aspects of healthy living that will assist the patient in managing her diabetes condition. This will also help Sandra release and manage her mental stress, irregular breathing issues, and heartbeat.
Summary
In summary, the patient has a chance to resolve her problem concerning type 2 diabetes mellitus. Taking the prescribed medication on time and engaging in exercise are vital. In addition, the patient suffers from hyperthyroidism and hyperglycaemia. The main cause of the such health-related problem of the patient is the patient’s unhealthy lifestyle, lack of exercise, and unhealthy diet.
References
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