Anatomy & Physiology 2 Case of the Chilling School Teacher Linda Johnson, a 40 y

Anatomy & Physiology 2
Case of the Chilling School Teacher
Linda Johnson, a 40 year-old female school teacher, reported to her family physician a three-month history of gradually progressive constipation. She told her physician that prior to three months ago, her bowel movements were normal and occurred once every day. Currently she was having only one bowel a movement every three days. Linda also told her physician that she felt cold all the time; when her family members were comfortable in a room with the thermostat set at 70°, she felt cold unless it was turned up to 74°.
Physical Examination:
Weight: 160 pounds (increase of 20 pounds from one year ago).
Height: 5 feet, 2 inches
Temperature: 96.8° Fahrenheit
Respirations: 12 / min
Pulse: 46 / min
Blood Pressure: 110/85.
Skin: Dry without any obvious rash.
Head: Thinner than normal and very dry.
Neck: Thyroid gland mildly enlarged and non-tender.
Neurologic exam: Deep tendon reflexes such as the ankle jerks showed slight “hang-up” — the relaxation phase seemed prolonged
Answer the following questions about this case
List your sources in the area indicated. No special formatting of sources. Just copy and paste the website you got your information from. If your information is from a book then you can do any formatting of your choice (MLA, CHICAGO, APA etc)
**You will need to supply a minimum of 6-8 sentences supporting each of your answers.
Questions:
1)What historical questions would you want to know regarding the patient’s mood, energy level, hand pain, and voice? What answers would you anticipate to these questions? *
2)What is Linda’s probable diagnosis? What historical and physical exam data support this diagnosis? *
3)What do you think the patient’s basal metabolic rate is: high, normal, or low? What historical or physical exam data supports your answer? What is the basal metabolic rate in most obese individuals?
4)Laboratory Results
The laboratory data revealed the following:
Thyroid Stimulating Hormone (TSH) = 8 mU/L (normal=0.4-5 mU/L)
Thyroxine (T4) = 50 nmol/L (normal-64-154 nmol/L)
Which of the above laboratory values rule out the pituitary as a cause of Linda’s problems?
5. Explain the patient’s lab values in terms of a positive or negative feedback mechanism