You have a patient complaining of fatigue and lethargy.She mentions that she recently went on a low-salt,all carbohydrate diet and consumes mostly rice.You notice a swelling in her neck.You order some blood work.Which of the following do you expect?
A)Low plasma concentration of thyroid hormones and thyroid-stimulating hormone (TSH)
B)Low plasma concentration of thyroid hormones
C)High plasma concentration of thyroid-stimulating hormone (TSH)but low thyrotropin-releasing hormone (TRH)
D)High plasma concentration of thyroid hormones due to increased secretion of TSH by the pituitary gland
E)Low plasma concentration of thyroid hormones and atrophy of the thyroid gland due to reduced concentrations of thyroid-stimulating hormone (TSH)

Question

Quizplus · Accepted Answer

The patient's symptoms, including fatigue, lethargy, and neck swelling, suggest hypothyroidism. The patient's recent diet that is high in carbohydrates and low in salt may have contributed to this condition. As a result, we would expect to see low plasma concentrations of thyroid hormones in the blood work as this is consistent with hypothyroidism. Option A is incorrect because it suggests low concentration of thyroid-stimulating hormone (TSH), but the question states there is swelling in the patient's neck, which can be caused by an enlarged thyroid gland (goiter) due to elevated levels of TSH. Option C is incorrect because high TSH levels suggest that there is not enough thyroid hormone being produced and secreted, which is not supported by the patient's symptoms. Option D is incorrect because high plasma concentration of thyroid hormones is not consistent with hypothyroidism. Option E is incorrect because low thyroid hormone levels are typically caused by reduced TSH secretion, not atrophy of the thyroid gland.

You Have a Patient Complaining of Fatigue and Lethargy