The Graves’ disease workshop was conducted by Mohamed Abdelnaby, a student in his second year of study. Below is the reformulated version of the text after rewriting it using natural language.

Question 1:

a) Graves’ disease is an autoimmune disorder that results from the excessive production of thyroid-stimulating immunoglobulins which bind to TSH, thereby leading to the production of T3 and T4.

b) Hyperthyroidism is characterized by a high basal metabolic rate which causes heat sensitivity, weight loss, palpitations, fatigue, anxiety, irritability, and agitation and also leads to exophthalmos.

c) The aforementioned symptoms are a key indicator for confirming hyperthyroidism.

d) Mrs. SM had already undergone blood tests that confirmed that she has Graves’ disease.

Question 2:

a) Thyroid crisis is a life-threatening acute disorder that results from hyperthyroidism. The typical approach to managing thyroid crisis is usually the administration of anti-thyroid medication.

Question 3:

a) Treatment options for Graves’ disease include anti-thyroid drugs, radioactive iodine, and surgery.

b) Anti-thyroid medications (Carbimazole and Propylthiouracil) are highly effective, particularly for mild cases of the disease. However, their side-effects include rash, irritation, aberrant hair loss, swelling, and heat intolerance.

c) Radioactive iodine treatment reduces thyroxine production and the size of the gland. However, its long-term usage may increase the risk of developing cancers such as leukaemia, stomach cancer, and salivary gland cancer.

d) Surgery is a highly effective approach that reduces the mortality rate and psychological issues of patients with minimal relapse risk. It may, however, lead to permanent hypothyroidism.

e) Side effects of the treatment options above include arthralgia, urticaria, dermatitis, transient inhibition in the production of thyroid hormones and permanent hypothyroidism.

f) Treatment options for Graves’ disease include the use of PTU to reduce thyroid hormone synthesis, Propranolol to help control symptoms that affect the heart, Prednisolone to suppress the immune system response, and Lacri-lube to alleviate ocular discomfort and pain.

Question 4:

a) During the first trimester of pregnancy, PTU is recommended. Methimazole can be used afterward as it is considered safe. Also, Propranolol, Prednisolone have risks, but their benefits outweigh them, while Lacri-lube does not affect pregnancy.

Question 5:

a) Exophthalmos refers to the thickening of the extraocular walls and swelling around the orbital soft tissue.

b) The onset of exophthalmos is the result of an auto-immune reaction caused by the immune system.

c) Management of exophthalmos usually involves the use of corticosteroids since they are immunosuppressant. Lacri-lube is also beneficial in alleviating the discomfort associated with the condition.