TY - CHAP M1 - Book, Section TI - Goitrous Hypothyroidism A1 - Smith, Mindy A. A2 - Usatine, Richard P. A2 - Smith, Mindy A. A2 - Mayeaux, Jr., E.J. A2 - Chumley, Heidi S. PY - 2019 T2 - The Color Atlas and Synopsis of Family Medicine, 3e 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. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - dermatology.mhmedical.com/content.aspx?aid=1164350156 ER -