Question

A 35-year-old female presents to your primary care office for review of her laboratory results. Her physical exam shows a blood pressure (BP) of 140/90, pulse (P) of 105, oxygen saturation of 97%, and temperature of 98.6°F. She has complaints of palpitations, weight loss, hair loss, and anxiety. Her labs are all normal except for a low thyroid-stimulating hormone (TSH) and an elevated thyroxine (T4). What would your next course of treatment be?

a. Start metoprolol and propylthiouracil (PTU).

b. Refer the patient to psychiatry for treatment of anorexia.

c. Refer the patient for radioactive iodine treatment.

d. Refer the patient for thyroidectomy.

Answer 1

The patient's symptoms and lab results indicate hyperthyroidism; the appropriate treatment would be to start metoprolol and propylthiouracil (PTU).

Step-by-step explanation:

The patient, a 35-year-old female with symptoms of palpitations, weight loss, hair loss, and anxiety, coupled with lab results showing low thyroid-stimulating hormone (TSH) and elevated thyroxine (T4), is likely suffering from hyperthyroidism. Hyperthyroidism is characterized by an overactive thyroid gland, which can lead to an increased metabolic rate, resulting in symptoms like weight loss, palpitations, and anxiety. Given her clinical presentation and lab results, the next course of treatment would be to start antithyroid medications to control her symptoms and the overactive thyroid function. Therefore, the most appropriate next course of treatment for this patient would be option a. Start metoprolol and propylthiouracil (PTU). Metoprolol is a beta-blocker that can help reduce symptoms such as palpitations and tremors, while PTU is an antithyroid medication that helps reduce the production of thyroid hormones.