Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
TBL – Task Based Learning TASK: Problem solving – You are a doctor. A patient comes in with signs of cachexia, very agitated, heart palpitations, and exophthalmos. Which of the following choices best describes her condition? Diagnosis : A) she has Hashimoto’s hyperthyroidism with low TRH and TSH levels. B) she has Hashimoto’s hyperthyroidism with high TRH and TSH levels. C) she has Hashimoto’s hypothyroidism with low TRH and TSH levels. D) she has Hashimoto’s hypothyroidism with high TRH and TSH levels. E) she has Graves’ hyperthyroidism with low TRH and TSH levels. F) she has Graves’ hyperthyroidism with high TRH and TSH levels. G) she has Graves’ hypothyroidism with low TRH and TSH levels. H) she has Graves’ hypothyroidism with high TRH and TSH levels. You must use your mobile phones to search for all the information you need. __________ Main linguistic structures involved: defining, comparing, contrasting, hypothesizing, explaining. Students will use all four language skills. __________ Solution: next page Solution of the problem solving task TRH (thyrotropin-releasing hormone): produced and secreted by the hypothalamus, it induces the releasing of the pituitary hormone TSH. TSH (thyroid stimulating hormone): produced and secreted by the anterior pituitary, it induces the production of thyroid hormones T3 and T4, which stimulate our metabolism. If the plasmatic levels of T3 and T4 are too high, we have an iperfunctioning of the thyroid gland (hyperthyroidism), which induces cachexia (excessive weight loss without apparent reasons), exophthalmos (protruding eyes), heart palpitations, agitation: the symptoms of our patient (the symptoms are the opposite if their level is too low). So she is suffering from hyperthyroidism (in this way, we can eliminate the options C, D, G, H). At this point, we have to decide if she is suffering from Hashimoto’s disease or Graves’ disease. Hashimoto’s disease: Graves’ disease: They are both autoimmune diseases: our antibodies attack our own body antibodies attack and destroy the thyroid gland, so it cannot produce and release T3 and T4. Hypothalamus detects the low levels of thyroid hormones and thus it releases TRH (negative feedback): in this way, pituitary is stimulated to produce TSH, and so the thyroid strives to produce its hormones T3 and T4, but it cannot do it because of the Hashimoto’s disease. The cycle begins again: in this way, TRH and TSH plasma levels increase, while T3 and T4 levels are low (hypothyroidism, whose symptoms are opposite to those of our patient). She does not suffer from the disease of Hashimoto: we can eliminate the options A and B. antibodies attack and stimulate the thyroid gland, so T3 and T4 blood levels increase. Hypothalamus detects the high levels of thyroid hormones and thus it does not release TRH (negative feedback): in this way, pituitary is not stimulated to produce TSH, and so the thyroid should stop producing T3 and T4, but it cannot do it because of the Graves’ disease. The cycle begins again: in this way, TRH and TSH plasma levels decrease. So, the Graves’ disease is characterized by high plasma levels of T3 and T4, and low plasma levels of TRH and TSH. The only possible options are E and F. The correct one if the option E. Diagnosis : she has Graves’ hyperthyroidism low TRH and TSH plasma levels. with