: A 38-year-old woman complains of feeling tired, chilled, and “mentally dull” o

Question

: A 38-year-old woman complains of feeling tired, chilled, and “mentally dull” over the past several months. She notes a decreased frequency of bowel movements & weight gain. She is 5'5" tall and weighs 125 lb. Her pulse rate is 56 BPM, & her blood pressure is 138/88 mm Hg. She has a slightly puffy face, & her eyebrows are sparse, especially laterally. Upon palpation, the thyroid feels inflamed.

Patient Normal Range
T4, Total (S) 4.8 ug/dl 5 - 11.5
T3, Total (S) 101 ng/dl 100 - 215
Free thyroxine index (FTI) 4.3 6 - 11.5
TSH (S) 22.0 mlU/L 0.7 - 7.0
Antithyroglobulin Ab. Pos. Neg.
Antimicrosomal Ab. Pos. Neg.
Cholesterol (S) 230 mg/dl 140 – 225

What is your diagnosis? Provide evidence (signs and symptoms) to support your answer completely.



How should this patient be treated?

Explanation / Answer

The diagnosis is hypothyroidism. The inflammed throat shows goitre which is a sign of hypothyroidism. The low FTI and low T4 levels are also a characteristic of hypothyroidism. The high TSH level is also a characteristic of hypothyroidism Cholesterol levels are also expected to be high in hypothyroidism ---------------------------------------- Hypothyroidism is treated with a mixture of levo-rotatory forms of T3 and T4.

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