Question

History: A 50 yearold housewife complains of progressive weight gain of 20 pounds in 1 year, fatigue, postural dizziness, loss of memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance.

Physical examination: Vital signs include a temperature 96.8 F pulse 58 minute and regular, BP 110/60. She is moderately obese and speaks slowly and has a puffy face, with pale, cool, dry, and thick skin. The thyroid gland is not palpable. The deep tendon reflex time is delayed.
Laboratory studies: CBC and differential WBC are normal. The serum T4 concentration is 3.8 ugdl N the serum TSH is 1 uUml N and the serum cholesterol is 255 mgdl N
What is the likely diagnosis?

Answer 1

The likely diagnosis for the presented case is hypothyroidism. Hypothyroidism is a condition in which the thyroid gland is underactive and does not produce sufficient thyroid hormones.

Step-by-step explanation:

The likely diagnosis for the presented case is hypothyroidism. Hypothyroidism is a condition in which the thyroid gland is underactive and does not produce sufficient thyroid hormones. The symptoms described in the patient, such as progressive weight gain, fatigue, postural dizziness, loss of memory, slow speech, deepening of voice, dry skin, constipation, and cold intolerance, are characteristic of hypothyroidism.

In hypothyroidism, the metabolic rate is low, resulting in weight gain and reduced mental activity. The cold intolerance is due to decreased heat production by the body. The low heart rate is a result of decreased thyroid hormone levels impacting the heart's function. Laboratory studies also support the diagnosis, with a normal TSH and low T4 concentrations.

Treatment for hypothyroidism involves thyroid hormone replacement therapy, which may be required for the rest of the person's life. It is important to monitor and manage hypothyroidism in pregnant women, as low thyroid hormone levels can have adverse effects on fetal brain development.