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A 34-year-old woman was playing golf with a group of friends. Over the course of her women’s league, she and her friends were noticing her game was starting to fall apart.  

Upon consultation with a physician, she reported feeling tired and weak a lot of the time, she had lost weight, and felt like she was always overheating. At her consultation, her BMI was low, she had lost 10kg since her last appointment. It was noted that she was having very mild swelling and bulging in her eyes. Her key bloodwork reported: 

T4 : 33 pmol /L ( typical range = 10 – 20)

T3 : 12 pmol /L ( typical range = 3.0 – 6.5) 

TSH : <0.01 mU /L,  Thyroperoxidase (TPO) antibodies raised in the 100's  The physician's diagnosis was Grave's disease. They referred GM to an endocrinologist for further bloodwork and prescribed over-the-counter artificial tears during the day and lubricating gels at night.   Questions:   List the SOAP notes from the patient's description above. (2) Subjective     Objective     Assessment     Plan       Which endocrine gland is primarily responsible for this case? (0.5) Thyroid gland       What classification (type) of hormone were tested? (1)       In an otherwise healthy individual, when T3 and T4 levels increase in the blood, what will happen to TSH?  (1.5) SCIENCE HEALTH SCIENCE NURSING HAP 101