History and Physical Exam
History
A 28-year-old woman with recent tiredness and difficulty concentrating had experienced a
decline in memory over the last several months. She also noted decreased frequency of bowel movements and
an increased tendency to gain weight. She felt chilled without light sweater, even in warm weather. There
was a history of hypothyroidism in her mother and older sister.
Physical Exam
She was 5'5" tall and weighed 125 lb. Her pulse rate was 58 beats per minute and her blood pressure was
138/88. She had a slightly puffy face and her eyebrows were sparse, especially at the lateral margins.
The thyroid was firm and bosselated to palpation with an estimated weight of 25 g (normal 15 - 20 g).
The deep tendon reflexes were normally contractive, but showed delayed relaxation.
Questions
- What do you think the patient's primary problem is?
- What laboratory tests would you order to evaluate this patient?