A 44-year-old woman comes to the physician because of a 3-month history of anxiety, difficulty falling asleep, heat intolerance, and a 6-kg (13.2-lb) weight loss. she also reports a double vision and worsening eye irritation. . The patient has no prior medical problems and takes no medications. Her pulse is 115/min and blood pressure is 140/60 mm Hg . Ophthalmologic examination shows swelling of the eyelids and proptosis bilaterally. Appropriate therapy is begun. On a follow-up visit 4 weeks later, her eye symptoms have improved, and examination reveals a small decrease in proptosis with no redness. The drug that improved her ocular symptoms most likely did so by affecting which of the following?

Question

A 44-year-old woman comes to the physician because of a 3-month history of anxiety, difficulty falling asleep, heat intolerance, and a 6-kg (13.2-lb) weight loss. she also reports a double vision and worsening eye irritation. .  The patient has no prior medical problems and takes no medications. Her pulse is 115/min and blood pressure is 140/60 mm Hg . Ophthalmologic examination shows swelling of the eyelids and proptosis bilaterally.   Appropriate therapy is begun.  On a follow-up visit 4 weeks later, her eye symptoms have improved, and examination reveals a small decrease in proptosis with no redness.  The drug that improved her ocular symptoms most likely did so by affecting which of the following?

Quizplus · Accepted Answer

Eductional Objective: Graves ophthalmopathy is caused by stimulation of orbital fibroblasts by thyrotropin receptor antibodies and cytokines released by activated T-cells.  Excess deposition of extracellular glycosaminoglycans and inflammatory infiltration lead to expansion of extraocular muscles and retro-orbital tissues.  Glucocorticoids improve Graves ophthalmopathy by decreasing the severity of inflammation and reducing the excess extraocular volume.

A 44-Year-Old Woman Comes to the Physician Because of a 3-Month