Case #5 A thirty-five year old female underwent total thyroidectomy for follicul

Question

Case #5 A thirty-five year old female underwent total thyroidectomy for follicular thyroid carcinoma (on biopsy) The patient recovered well the first few days post surgery. On day three, she started to notice issues of lowered threshold for nerve and muscle excitation leading to muscle spasms and h developed dry skin, loss of body hair, and clonic-tonic convulsions. yperreflexia. She later .Describe the parathyroid and calcitonin hormones with respect to where they are produced and released from; their physiological functions, and target organs. (Be specific) . What is the most likely underlying cause to her symptoms? .What follow-up measures should be taken post-thyroidectomy? 26

Explanation / Answer

1. The parathyroid hormone(PTH) is produced and secreted by the parathyroid glands that are situated behind the thyroid gland in the neck.The parathyroid hormone function to increase the calcium ion levels in the blood serum when it becomes low and they do so by acting on it target organs i.e binds to the parathyroid hormone 1 receptor that is present at increased levels in the bone and kidney and the parathyroid hormone 2 receptor that is present at high levels in the central nervous system, testis, and placenta and pancreas.

Calcitonin hormone is produced and secreted by the parafollicular cells of thyroid glands.This hormone functions to reduce the Ca+ levels in the blood serum.The target organ is bone,kidney,some regions of brain, testes in males and ovary in females.

2.The underlying cause to her symptoms is hypoparathyroidism which might be caused due to damage to the parathyroid glands during thyroidectomy.Damaged parathyroid gland would fail to produce and secreted parathyroid hormones leading to hypoparathyroidism in which the calcium levels in blood become abnormally low and an increased amount of phosphorus build up in the blood resulting in the symptoms seen.

3.Post thyroidectomy, the women should take thyroid hormone tablets and calcium carbonate and Vitamin D pills to restore the normal calcium levels in the body and to get relieve from the synptoms that are seen.

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