Reference no: EM133729127

Problem

Chief Complaint (CC): "I have been feeling fatigued in the last 3 months. I have gained 4 pounds of weight, which is scaring. I find it hard to deal with coldness, experienced muscle cramps and constipation in the past 1 month. ". History of Present Illness (HPI): Maxine Kerry is a 45-year-old woman. She presents with feeling fatigue most of the time in the past month. She is ever feeling cold, in the morning and evenings. She has been having joint pain and muscle cramps and has gained weight contrary to her wishes. The symptoms are of a gradual onset, not aggravated by anything nor relieved by anything. Medications: she is diabetic. On insulin subcutaneous twice daily. Allergies: She reports no allergy to drugs, allergic to eggs. Past Medical History (PMH): She reports a history of hospitalization when she was 30 years old due to diabetes, no blood transfusion. Current medication: insulin for diabetes management. Past Surgical History (PSH): she had her 3 babies through caesarean section. Family History: What is the presumptive diagnosis is and 3 other thryriod relating differiential and define each diagnosis and explain why each differential diagnosis was rule out.