Reference no: EM133877596

Question

A 45-year-old woman, presents to your clinic with complaints of weight gain, fatigue, and constipation over the past six months. She mentions feeling cold even in warm weather and has noticed dry skin and thinning hair. Emilee works as a research librarian and admits to feeling more forgetful lately, which concerns her and makes getting through her workday more difficult. Medical History Hypertension controlled with amlodipine Family history: Her mother had hypothyroidism Social History Non-smoker, occasional alcohol consumption (1 to 2 glasses of wine 2 times weekly) Exercises sporadically due to fatigue Medications Amlodipine 5 mg daily Daily multi-vitamin Magnesium Citrate at bedtime for sleep Clinical Presentation Emilee appears tired and slightly overweight. Her skin is dry with no rashes or lesions. Thinning of her eyebrows is noted. The thyroid gland is palpated and found to be non-tender but enlarged. The lungs are CTA, HRR with no murmur, normal ROM, alert, and respond appropriately. Vital signs: BP 130/80 mmHg, HR 64 bpm, Temp 36.5°C, BMI 28 Diagnostic Testing Results Complete Blood Count (CBC) Hemoglobin (Hb): 11.5 g/dL (normal range: 12.0 to 15.5 g/dL) Hematocrit (Hct): 34% (normal range: 36% to 46%) Mean Corpuscular Volume (MCV): 95 fL (normal range: 80 to 100 fL) White Blood Cell (WBC) Count: 7.2 x 10^3/µL (normal range: 4.0 to 11.0 x 10^3/µL) Differential: Neutrophils: 60% (normal range: 40% to 70%) Lymphocytes: 30% (normal range: 20% to 40%) Monocytes: 6%