Reference no: EM133314782

Question 1: A 28 year old male who lives with his parents, reports to the clinic with a chief complaint of gradual onset of weakness and fatigue. He has used almost all of his sick days due to feeling nauseous and vomiting while at work and occasionally before coming to work. He reported a slight decrease in his weight and not being hungry nearly as often. He complains that food tastes bland and he uses a lot of salt to make it taste better. He states being nervous about eating certain foods when he is hungry due to diarrhea which he has not figured out the cause of. When asked, he states that his tanned skin from the summer has not faded like it usually does even though it is well into the winter months (January) and that he does not use a tanning bed. He states his parents are worried because he is quick to become irritated with them and rarely comes out of his room when at home.

Considering that his condition is due to a hormonal imbalance, which endocrine disorder do you suspect? What hormones would you measure to ascertain a diagnosis? How would you justify your clinical diagnosis by linking this to the pathophysiological changes in this patient?

Question 2: A 50 year old housewife complains of progressive weight gain of 20 pounds in 1 year, fatigue, postural dizziness, loss of memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance. Physical examination reveals a BP 110/60., moderate obesity, puffy face, with cool, dry, and thick skin. Her thyroid gland is not palpable. The deep tendon reflex time is delayed.

Suspecting that her condition is due to thyroid hormone imbalance, what laboratory tests would you recommend? What changes do you expect to see in the hormonal levels? How would correlate the clinical signs and symptoms stated here with the pathophysiology of her condition?