Hashimoto thyroiditis Quiz: Ace Your Exams
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A 67-year-old man comes to the physician complaining of decreased concentration for the last 5 months. He is no longer able to complete his daily crossword puzzles due to lack of focus and a persistent feeling of fatigue. His partner states that he has been more forgetful recently, oftentimes misplacing common objects such as his glasses and wallet. The patient has gained 12-lb in the last 4 months without a change in diet or activity level. Past medical history is significant for hypertension, which is being treated with lisinopril. The patient has had no changes in vision, headaches, or loss of peripheral sensation. Temperature is 37.0°C (98.6°F), pulse is 50/min, blood pressure is 128/86 mm Hg, and BMI is 27 kg/m2. Physical examination shows dry skin and a slightly distended abdomen. Deep tendon reflexes are delayed in the upper and lower extremities. Laboratory studies show the following:
Which of the following is the most likely cause of this patient’s condition?
| Laboratory value | Result |
| Sodium | 137 mEq/L |
| Potassium | 4.8 mEq/L |
| Chloride | 99 mEq/L |
| Creatinine | 0.6 mg/dL |
| Glucose | 89 mEq/L |
| TSH | 8.8 μU/mL |
| Hemoglobin | 12.6 g/dL |
| Hematocrit | 42% |
Which of the following is the most likely cause of this patient’s condition?
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