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981
his case scenario suggests a hyperthyroidism condition, likely due to Graves' disease or a toxic multinodular goiter. The patient's symptoms, physical findings, and laboratory results point towards an overactive thyroid gland.
1) Differential Diagnosis
Graves' disease: An autoimmune disorder causing hyperthyroidism.
Toxic multinodular goiter: Multiple thyroid nodules producing excess thyroid hormone.
Toxic adenoma: A single thyroid nodule producing excess thyroid hormone.
2) Specific Tests
Thyroid-stimulating immunoglobulins (TSI): To check for Graves' disease.
Radioactive iodine uptake (RAIU) test: To measure thyroid function.
Ultrasound of the thyroid: To assess the size and structure of the nodules.
Fine-needle aspiration biopsy: To rule out malignancy.
3) Symptoms Consideration
Nervousness, weakness, palpitations: Common symptoms of hyperthyroidism.
Excessive sweating, heat intolerance: Indicative of increased metabolism.
Increased appetite with maintained weight: Suggestive of hyperthyroidism.
Bounding pulse, tachycardia: Physical signs of hyperthyroidism.
Thyroid nodules: Palpable nodules on physical examination.
4) Steps of Thyroid Hormone Biosynthesis
Iodide trapping: Iodide is actively transported into the thyroid follicular cells.
Iodide oxidation: Iodide is oxidized to iodine by thyroid peroxidase.
Iodination of tyrosine: Iodine binds to tyrosine residues in thyroglobulin to form monoiodotyrosine (MIT) and diiodotyrosine (DIT).
Coupling of MIT and DIT: MIT and DIT couple to form triiodothyronine (T3) and thyroxine (T4).
Proteolysis of thyroglobulin: Thyroglobulin is broken down to release T3 and T4 into the bloodstream.
Transport: T3 and T4 are transported via binding proteins in the blood.
5) Anatomical Structure of the Thyroid Gland
The thyroid gland is a butterfly-shaped gland located in the anterior neck, just below the larynx. It consists of two lobes connected by an isthmus. The gland is highly vascularized, supplied by the superior and inferior thyroid arteries, and drained by the superior, middle, and inferior thyroid veins.
6) Histological Cell Structure
The thyroid gland contains thyroid follicles, which are the functional units. Each follicle is lined by a single layer of simple cuboidal epithelial cells called thyrocytes. The follicles are filled with a protein-rich colloid1. Parafollicular cells (C cells) are located between the follicles and secrete calcitonin, which helps regulate calcium metabolism.
981
محاضرات protein metabolism غير داخلة للامتحان النصفي
اما amino acids and protein chemistry داخل
981
قالتلهم على شابتر هو من الأصل مش داخل انه مش داخل باش تحسسهم المنهج شويه وحاطين قلوب للرساله 🤯
981
السلام عليكم
بنسال على اللي كاتبه هني هل هوا صح ؟
مااقتنعتش بيه لان شن جاب post لل ventral root
