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5. Diagram the feedback loop involved.
6. What is a palpable goiter, and would you expect to find a palpable goiter in this case? Explain
your answer. A 30-year-old female demonstrated a subtle onset of the following symptoms: dull
facial expression; droopy eyelids; puffiness of the face and periorbital swelling; sparse, dry hair;
dry, scaly skin; evidence of intellectual impairment; lethargy; a change of personality;
bradycardia (60b/min); a blood pressure of 90/70; constipation, and hypothermia. The patient
does not complain of pain. Plasma concentrations of total and free T4 and T3 follow: A blood
sample indicated elevated TSH levels. A TSH stimulation test did not increase the output of
thyroid hormones from the thyroid gland. A biopsy of her thyroid revealed large numbers of
lymphocytes in her thyroid gland.

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