D. graves disease may have a heritable component. what future testing would you suggest for hayden

Hayden's blood samples at 3 months shows high thyroid levels of 22.2 μg/dL which is higher than normal range of 6-15 μg/dL. Moreover, his TSH values are on borderline on lesser side of range i.e. 0.3 μg/dL when normal range is 0.3-3.04 μg/dL. These Observations are alarming and an antibody test is highly recommended to see if hyperthyroidism is attributed to Graves disease.

Explanation:

Graves disease may have a heritable component because it is possible that any gene or genes alteration in the family tree may have inherited by the patient. It is an autoimmune disorder in which antibodies are formed against the thyroid-functioning of pituitary gland resulting into overproduction of thyroid hormones known as hyperthyroidism. The thyrotropin receptor antibody (TRAb) are produced in Graves disease which mimics the function of regulatory pituitary hormones. Physical examination is performed to see if the thyroid gland is enlarged due to overproduction of hormone. Blood samples are taken to assess the thyroid-stimulating hormone (TSH) levels which are lower than normal in blood due to high amount of thyroid hormone in circulation. The levels of thyrotropin receptor antibody (TRAb) in blood is also assessed to confirm if the cause of hyperthyroidism is none other than Graves disease.

low context culture   (lc.):

association:    

relationships begin and end quickly. many people can be inside one's circle; circle's boundary is not clear.

things get done by following procedures and paying attention to the goal.

one's identity is rooted in oneself and one's accomplishments.

social structure is decentralized; responsibility goes further down (is not concentrated at the top).

interaction:

low use of nonverbal elements. message is carried more by words than by nonverbal means.

verbal message is explicit. context is less important than words.

verbal message is direct; one spells things out exactly.

communication is seen as a way of exchanging information, ideas, and opinions.  

disagreement is depersonalized. one withdraws from conflict with another and gets on with the task. focus is on rational solutions, not personal ones. one can be explicit about another's bothersome behavior.

territoriality:

space is compartmentalized and privately owned; privacy is important, so people are farther apart.

temporality:

things are scheduled to be done at particular times, one thing at a time. what is important is that activity is done efficiently.

change is fast. one can make change and see immediate results.

time is a commodity to be spent or saved. one’s time is one’s own.

learning:

reality is fragmented and compartmentalized. one source of information is used to develop knowledge. thinking is inductive, proceeds from specific to general. focus is on detail.

learning occurs by following explicit directions and explanations of others.

an individual orientation is preferred for learning and problem solving.

speed is valued. how efficiently something is learned is important.

hope that                                         : )