BOF: 3.15
A 32-year-old female presents with a history of tremor
and heat intolerance of 3 months duration. She has lost weight and felt more
tired than usual. Her periods were regular. She had episodes where she felt
her heart racing. No serious past illnesses. There was family history of
hypothyroidism. She smokes 10 cigarettes a day and takes alcohol occasionally.
On examination she was thin, had a fine tremor of her hands pulse 110 beats
per minute sinus rhythm. She had diffuse enlargement of her thyroid gland but
had no eye signs. Reflexes were symmetrical and brisk.
After being told the diagnosis she says she is planning
to become pregnant and asks what effect pregnancy would have on this
condition. Your reply would be that this condition:
a)
Improves during pregnancy but relapses in the puerperium
b)
Improves during pregnancy and the puerperium
c)
Deteriorates during pregnancy but improves during the puerperium
d) Deteriorates
during pregnancy and the puerperium
e)
Pregnancy has no effect on the condition
Answer: a)
Like most autoimmune conditions Grave’s disease often
enters remission during pregnancy but relapses during the puerperium
Revision Tip
Revise thyrotoxicosis KEYS to
SUCCESS in Medicine page 24-26
