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C.R., a 27-year-old woman, has a 3-month history of intermittent heat intolerance, sweats, tremor, and severe muscle weakness, which has limited her ability to climb

C.R., a 27-year-old woman, has a 3-month history of intermittent heat intolerance, sweats, tremor, and severe muscle weakness, which has limited her ability to climb stairs. Her weight has increased because of increased appetite. She is also bothered by the pounding of her heart and some minor difficulty in swallowing. There is a family history of thyroid disease, but she denies taking any thyroid medications or any history of radiation to her neck. C.R. previously received iodide drops with symptomatic improvement but her disease recurred despite its continued administration. Her other medical problems include type 2 diabetes controlled by diet, and osteoarthritis treated with aspirin 650 mg orally (PO) every 4 hours. She has a history of noncompliance with her clinic visits. Pertinent physical findings include a blood pressure of 180/90 mm Hg, a pulse of 110 beats/minute, hyperreflexia, lid lag, and a diffusely enlarged thyroid gland that is about four times normal (about 100 g). Laboratory data include the following: TT4, 6 mcg/dL (normal, 4.8–10.4) FT4, 3.9 ng/dL (normal, 0.7–1.9) TSH, <01 microunits/mL (normal, 0.4–4.0) TRAb, + Fasting blood glucose, 350 mg/dL (normal, <100mg/dL) 


1.Which of the following is most likely CR’s diagnosis?


2. Which laboratory test confirms your answer in number 1? Describe the purpose of this test to support your answer.


3. Identify 3 signs or symptoms and correlate each of these to the pathophysiology of CR's disorder. Provide brief answers by using bullets.



4. 

After taking her Iodide drops, why do you think CR's disease still recurred? Answer in 3-5 sentences

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1 The most likely diagnosis for CR is Graves disease an autoimmune disorder that causes hyperthyroid... blur-text-image

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