RT Book, Section
A1 Smith, Mindy A.
A2 Usatine, Richard P.
A2 Smith, Mindy A.
A2 Mayeaux, Jr., E.J.
A2 Chumley, Heidi S.
SR Print(0)
ID 1164350156
T1 Goitrous Hypothyroidism
T2 The Color Atlas and Synopsis of Family Medicine, 3e
YR 2019
FD 2019
PB McGraw-Hill Education
PP New York, NY
SN 9781259862045
LK dermatology.mhmedical.com/content.aspx?aid=1164350156
RD 2024/04/19
AB A  55-year-old  woman  presented  with  a  several-month  history  of  fatigue  and  weight  gain.  She  reported  that  she  felt  puffy  and  swollen.  She  had  difficulty  buttoning  the  top  button  of  her  blouse  because  her  neck  was  so  large,  but  she  reported  no  neck  pain.  Review  of  systems  was  positive  for  constipation,  dry  skin,  and  cold  intolerance.  On  physical  examination,  a  large  goiter  was  found  (Figure  235-1).  Laboratory  testing  revealed  an  elevated  thyroid-stimulating  hormone  (TSH)  and  a  low  free  thyroxine  (FT4)  level,  confirming  hypothyroidism.  The  patient  was  started  on  levothyroxine.