[Solved]: A 49-year-old male patient presents to your clinic…

A 49-year-old male patient presents to your clinic complaining of fatigue, constipation, lethargy, and intolerance to cold. He is on conservative treatment for mild hypertension “low salt diet”, he has no outstanding history of prior illness or family disease. He is a farmer and consumes a predominantly vegetarian diet, with water derived from a local well. On physical examination, you notice an enlarged mass in the anterior part of his neck, which he has noticed has been slowly growing. His vital signs were as the following: heart rate, 60 bpm; blood pressure, 110/70 mmHg; temperature, 37.8deg C. Which of the following would you expect to be an underlying mechanism in pathophysiology in this case? • a. Increased deiodinase type Ill activity • b. Increase Follicular cell iodine concentration O c. None of them O d. Decreased thyroid peroxidase activity • e. Decreased hepatic thyroid-binding globulin synthesis