A pregnant patient complains of severe fatigue and exercise intolerance. Laboratory tests that should be investigated include:
A. CBC
B. TSH
C. T4
D. All of the above
ANS: D
Fatigue usually occurs during the first and third trimesters of pregnancy. First-trimester fatigue is often associated with the physical and psychosocial pregnancy changes. Fatigue may also be indicative of a more serious physical, emotional, or dietary problem. The woman may experience a higher than expected amount of fatigue despite a normal amount of energy expenditure and sleep. Vital signs and physical examination, with attention to the thyroid, cardiac, and pulmonary systems, should be normal. Weight gain during the pregnancy should be noted. A CBC and thyroid function tests (TSH and free T4) are reasonable choices for screening.
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