Hypothyroidism
• Concept and Etiology: Hypothyroidism is a condition of the thyroid gland in which
it doesn’t produce adequate amounts of thyroid hormones to keep the body
functioning properly (Story, 2017). The most common causes of hypothyroidism
include the autoimmune disease called Hashimoto’s thyroiditis or medical
treatments such as iodine radiation therapy resulting in iatrogenesis. Surgical
removal of the thyroid gland is also a common cause of hypothyroidism (ATA, n.d).
Some of the least common causes of hypothyroidism are insufficient or excessive
amounts of iodine, certain medications (lithium or amiodarone), congenital
hypothyroidism, thyroiditis and damage to the pituitary gland. This condition
deviates from the definition of health because it inhibits the secretion of thyroid
hormones that are responsible for metabolic reactions such as helping regulate body
temperature, producing energy, and enabling the brain, heart, muscles and major
organs to function optimally (ATA, n.d).
• Classification: Hypothyroidism can be classified as a metabolic disorder because of
the way it negatively impacts the hormones responsible for metabolism causing
bodily functions to slow down.
• Clinical Manifestations: Some symptoms of hypothyroidism include, fatigue,
constipation, unexplained weight gain, muscle weakness, myalgia, depression and
forgetfulness. Some signs of hypothyroidism are pale dry skin, increased sensitivity
to cold temperatures, edema of the hands and feet, hypotension,
hypercholesterolemia, brittle finger nails, hair loss, goiter, having a lower or hoarse
tone of voice and physical changes in the face such as drooping eyelids and
puffiness (Cleveland Clinic, 2020).
• Diagnostic Tests: In order to diagnose hypothyroidism health providers would
perform physical examinations, review patient’s medical history, test blood for
serum thyroid hormone levels and serum TSH levels. Other diagnostic tests include,
complete blood count (CBC), liver function tests, electrocardiogram and cholesterol
panel (Story, 2017).
Concept and Etiology: A traumatic brain injury occurs when there is a sudden violent blow
to the head that disrupts normal brain function. There are two variations which include a
closed injury and open injury. An open injury occurs when there is a penetrating wound to
the head. When the brain collides with the skull it causes the brain to bruise and damage to
nerve fibres and hemorrhage can occur. (Story, 2018) These injuries can increase the risk
for seizures, migraine headaches, Alzheimer’s disease and Parkinson’s disease (Story,
2018).
Classification:
• Males (nearly three times as likely as females to have a TBI)
• Young children (0- to 4-year-olds) and 15- to 19-year-olds
• Adults 65 years of age or older
• Certain military personnel (e.g., paratroopers)
• African Americans (highest death rates)
• Individuals with a history of substance abuse
This disease can occur suddenly, or it can go undetected for years depending on the
severity and symptoms that an individual experiences (Story, 2018).
Clinical Manifestations:
• Indications of a concussion (e.g., amnesia, confusion, and headache)
• Changes in or unequal size of pupils
• Seizures
• Asymmetrical facial features
• Fluid draining from the nose, mouth, or ears (may be clear or bloody; likely CSF)
• Fracture in the skull or face, bruising of the face, swelling at the site of the injury, or
scalp wound
• Impaired hearing, smell, taste, speech, or vision
• Inability to move one or more limbs
• Irritability (especially in children), personality changes, or unusual behavior
• Loss of consciousness
• Bradypnea (slowed breathing)
• Hypotension
• Restlessness
• Lack of coordination
• Lethargy
• Stiff neck
• Vomiting (Story, 2018)
Diagnostic Tests:
Diagnostic procedures for TBI consist of a history, physical examination, head CT, head
MRI, and ICP monitoring (Story, 2018). Treatment strategies vary depending on the
severity and the time since injury (Story, 2018). Immediate emergency care for TBI
focuses on limiting brain damage (Story, 2018)
Alzheimer's Disease is a disease that affects the brain and nervous system. It can cause the
nerve cells in the brain to die. This disease gets worse over time, it’s also known as a type
of dementia. There is no cause of the disease, some doctors think it could be caused due to
age, family history genes, or Immune system problems. This disease can be classified as
early-onset which means from early ages forties to sixties or late-onset. Signs that some
patients may show would be Memory loss, especially short-term memory loss. Difficulty
doing normal daily tasks, difficulty speaking, Confusion about time and place, Misplacing
things, mood changes, or behavior.
Seeing a Neurologist will ask questions regarding overall health, past medical history, and
family history. They will do a mini-mental at the neurologist's office, which is a test asking
some questions or saying words, and go back to it about five minutes later asking the
patient at that time do they remember the words that were just asked earlier in the
appointment. The provider will ask the family if they notice any changes in behavior or
personality. The doctor may order blood and urine tests to find possible causes of the
problem. CT, MRI of the Brain, or position emission tomography is also known as Pet scan
all can be used to rule out other causes of the problem.
Concept and Etiology
A cerebral aneurysm can be described as a weak blood vessel in the brain, that then
balloons and fills with blood. This vessel can then leak or rupture, which could cause life
threating bleeding. There are no symptoms if the vessel does not rupture. So, finding this
condition early is crucial for a patient's health. In regards to the week one discussion of
health, a cerebral aneurysm may not have immediate impact on health if it does not rupture.
However, if it does rupture it greatly affects the patients’ health and they could be in
immediate danger of bleeding out
Classification
A cerebral aneurysm is classified by the type and the size. The size's being small (less
than 11 millimetres diameter), large(11-25 millimetres) and giant( > 25 millimetres). Also,
the types include, saccular, fusiform and mycotic. Saccular aneurysm is the most common
and is when the blood is in a rounded sac connected to the main artery or one of its
branches. Fusiform is when the aneurysm balloons on all sides of the artery. Lastly
mycotic is when an infection affects arteries in the brain, thus weakening the artery wall
and causes an aneurysm to form.
Clinical Manifestations
Symptoms: There are no clear symptoms unless the aneurysm is very large or ruptures.
Pain above and behind the eye, double vision, nausea, stiff neck, sensitivity to light,
vomiting, numbness, weakness
Signs: dilated pupils, paralysis on one side of face, loss of consciousness, seizure, cardiac
arrest
z
Diagnostic Tests
z CT Scan - Computed tomography
z MRI - Magnetic resonance imaging
Cerebral angiography - finds blockage in arteries in brain or neck. Can also identify
weak spots in an artery.
Resources
U.S. Department of Health and Human Services. (n.d.). Cerebral aneurysms fact sheet.
National Institute of Neurological Disorders and Stroke. Retrieved November 22, 2021,
from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-
Sheets/Cerebral-Aneurysms-Fact-Sheet#3.
https://www.urmc.rochester.edu/encyclopedia/content.aspx
Story, L. (2018). Pathophysiology: A Practical Approach. Burlington: Jones & Bartlett
Learning.
American Thyroid Association (ATA). (n.d). Hypothyroidism FAQs.
https://www.thyroid.org/hypothyroidism/
Cleveland Clinic. (April 19, 2020). Hypothyroidism.
https://my.clevelandclinic.org/health/diseases/12120-hypothyroidism#symptoms-and-
causes
Story, L. (March 1, 2017). Pathophysiology: A Practical Approach, (3rd ed).
https://bookshelf.vitalsource.com/books/9781284142983
