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Patient case: Hypothyroidism

Patient case: Hypothyroidism

Discussion

A 45-year-old woman presents to the clinic with complaints of persistent fatigue, weight gain, and feeling cold all the time, even in warm weather. She reports that her symptoms have gradually worsened over the past six months. Additionally, she has noticed constipation, dry skin, and hair thinning. She denies any significant changes in diet or exercise.

On examination, the patient appears tired, with dry, coarse skin and mild swelling in her face and eyelids. Her heart rate is slightly below normal at 58 beats per minute, and her thyroid gland feels slightly enlarged but non-tender.

Laboratory tests reveal elevated levels of thyroid-stimulating hormone (TSH) and low free thyroxine (T4), consistent with primary hypothyroidism. The patient is diagnosed with hypothyroidism and started on levothyroxine therapy, with regular follow-up appointments scheduled to monitor her response to treatment.

Her symptoms gradually improve with medication, and she reports feeling more energetic within a few weeks of starting treatment.

Questions

1. Which of the following is a common symptom of hypothyroidism?

A) Weight loss

B) Fatigue

C) Heat intolerance

D) Insomnia

2. What was the likely lab finding in this patient with hypothyroidism?

A) Low TSH, high T4

B) High TSH, low T4

C) High TSH, high T4

D) Low TSH, low T4

3. Which medication is typically used to treat hypothyroidism?

A) Levothyroxine

B) Metformin

C) Insulin

D) Methimazole

4. What is a common physical sign of hypothyroidism seen in this patient?

A) Tremors

B) Facial swelling

C) Palpitations

D) Hyperactivity

Reveal answers

Answers

1. B) Fatigue

2. B) High TSH, low T4

3. A) Levothyroxine

4. B) Facial swelling