Allison is a 32-year-old female with the following symptoms: dismal facial expression; droopy eyelids; swollen face and periorbital areas; thin, dry hair; dry, crusty skin; evidence of intellectual impairment; lethargy; a change of personality; bradycardia (59 b/min); blood pressure of 93/72; anemia (hematocrit 28); enlarged heart (upon radiological exam); constipation, and hypothermia. Plasma concentrations of total and free T4 and T3 include:

1. What endocrine organ is involved in this situation?

2. Is this a primary or secondary disorder? Explain.

3. Describe the feedback loop involved. Signify if there is an increased or decreased TSH level.

4. List several defects or disorders that could cause these symptoms

5. Would you expect to find a palpable goiter? Why?

6. Describe an appropriate treatment for this patient.