A 40-year-old female went to her physician because she was feeling tired all the time. She had gained about 10 pounds in the last few months and exhibited some facial puffiness. Her thyroid gland was enlarged and rubbery. Laboratory results were as follows: Studies Value Normal Range Hemoglobin 12.7 g/dL 12-16 g/dLS-TSH 7.7 U/mL 2.3.4.0 U/mLAnti-TPO 0.8 ng/mL 1.0-2.0 ng/mL Free thyroxine (fT) 715 IU/mL <10.0 IU/mL 1. 1. What is the likely diagnosis in this case (be specific)? Explain your reasoning for this decision. 2. What other antibody(ies) would likely be found in this condition? Should a test for this/these antibody(ies) be performed to confirm diagnosis? Explain your reasoning. 3. Explain the specific mechanism of how anti-TPO effects thyroid function? 4. In what other condition can anti-TPO be found? How can this condition be differentiated from the condition experienced by this patient?
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