Discuss the enlargement found in Helena’s neck

Helena thought she was probably getting the menopause, as she knows that this is often characterised by hot flushes. She tires easily, but put this down to working long hours and getting older. None of these symptoms gave Helena any real cause for alarm. However, what made her think that there might be something wrong is the increasing amount of heart palpitations she has she can feel her heart racing quite quickly.

Helena has been feeling more anxious and suspects that this is because her fast heart rate makes her quite worried. So she decides to seek medical attention. Physical examination reveals tachycardia (a high heart rate of 109 beats per minute), hyper tension (high blood pressure of 150/90) and a high respiratory rate (22 breaths per minute). Her eyes appear somewhat wide open and there is an enlargement in the anterior (front) of her neck.

Answer all questions


  • Which endocrine disorder is consistent with Helena’s signs and symptoms?
  • Discuss the enlargement found in Helena’s neck.
  • Explain why it might be possible to have low levels of thyroid‐ stimulating hormone and high levels of thyroid hormone.
  • Relate Helena’s symptoms to your diagnosis of the disorder?

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