A 22-year-old female patient complains of excessive thirst, feeling "shaky when she misses meals" and increased frequency of urination. Family history is positive for cardiovascular disease, cerebrovascular disease, and diabetes
The patient denies use of tobacco, alcohol, or other drugs. She takes no medication. Daily diet is fast food, and the patient does not exercise regularly. On physical examination, there are no significant findings except obesity, demonstrated by a BMI of 35 and blood pressure of 145/ 90. The signs and symptoms are characteristic of:
A. Type 2 diabetes mellitus
B. Chronic fatigue syndrome
C. Cushing's disease
D. Clinical depression
ANS: D
The incidence of hypothyroidism is greater in women and more common in people over 40 years of age. Because the onset of hypothyroidism can be insidious, patients may not be aware that their thyroid levels have diminished. Common signs and symptoms include fatigue or lack of energy, puffy face, constipation, intolerance to cold, hypotension, bradycardia, dry skin, menorrhagia, modest weight gain, diminished deep tendon reflexes (DTRs), and dulled cognition.
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