MANCHESTER METROPOLITAN UNIVERSITY
Blood Science
Tutorial 2
Aims:
1. To consolidate clinical biochemistry topics from your lecture programme.
2. To encourage you to research information and become independent learners.
3. To apply principles of clinical biochemistry to clinical problem solving.
Question 1: A 50 year old women complains of tiredness and proximal muscle wasting. The GP
sends a sample to the local laboratory were the following results are obtained.
Analyte Result Reference Range
TSH 20 0.4 – 5 IU/L
Free T4 6 10 – 20 pmol/L
The thyroid gland is abnormal. In your answers you should consider the regulation of hormones.
A) Explain the concept of negative feedback in relation to the physiological
control of the thyroid gland.
B) List three symptoms of hypothyroidism.
C) The GP knows that the results are indicative of hypothyroidism but is unsure as to
whether the abnormality is in the thyroid gland or the pituitary. Advise the GP as to
whether the abnormality is in the pituitary or the thyroid gland. Justify your answer.
D) Using your knowledge of negative feedback what pattern of results would you
expect to see in a patient with primary hyperthyroidism.
Blood Science
Tutorial 2
Aims:
1. To consolidate clinical biochemistry topics from your lecture programme.
2. To encourage you to research information and become independent learners.
3. To apply principles of clinical biochemistry to clinical problem solving.
Question 1: A 50 year old women complains of tiredness and proximal muscle wasting. The GP
sends a sample to the local laboratory were the following results are obtained.
Analyte Result Reference Range
TSH 20 0.4 – 5 IU/L
Free T4 6 10 – 20 pmol/L
The thyroid gland is abnormal. In your answers you should consider the regulation of hormones.
A) Explain the concept of negative feedback in relation to the physiological
control of the thyroid gland.
B) List three symptoms of hypothyroidism.
C) The GP knows that the results are indicative of hypothyroidism but is unsure as to
whether the abnormality is in the thyroid gland or the pituitary. Advise the GP as to
whether the abnormality is in the pituitary or the thyroid gland. Justify your answer.
D) Using your knowledge of negative feedback what pattern of results would you
expect to see in a patient with primary hyperthyroidism.
