[Answered]: Eva, a 31 year old female visits an endocinologist…

Eva, a 31 year old female visits an endocinologist due to symptoms of fatigue, consipation, and menstraul irregularities. Her obstitrician is concerned with her 1 year struggle of trying to get pregnant and possible inferility concerns and referred her to this specialist. The doctor palpates the presence of thyromegily on the anterior neck and visibly notices dry brittle hair and nails along with patches of dermitis on the patient’s skin. The doctor orders a CBC w/diff to evaluate hormone levels and the results come back showing significantly elevated TSH and decreased T4 hormone levels which indicates a diagnosis of hypothyridism. The doctor attributes this to the dry skin, fatigue, digestion, and menstruation concerns. The doctor discusses the possibility of Hashimoto’s thyroiditis, an auto-immmunne disease that correlates with hypothyroidism. If her thyroid issues are left untreated it can affect her immune system, lowering her leuckocyte count and increasing risks of illness. She prescribes her Levothyroxine and orders blood work to be performed again in 4 weeks to re-assess the hormone levels. The doctor reviewed the medication with her and advised her that osteprosis is a possible side effect of prolonged medication use when she is post-menopausal. Case Study 2 Michael, a 62 year old male visits with his primary care physician. He has been experiencing fatigue, change in appetite and frequently waking up during the night to urinate. He has dyspnae and tires quickly with exertion. Due to past cardiac issues including a diagnosis of hypretnsion his doctor orders blood work and an adbominil CT scan. After receiving the results of the CT scan, his primary refers him to a cardeopulminoligist. The specialist believes his polyria is related to the side effects of his high blood pressure medication, Lisinopril, on his kidney function. The CT scan showed cardimegily and atherosclerotic hardening of the abdominal aorta and costocondretis in the chest cavity. She wants to assess pulmonary function and orders a spirimetry test and full panel blood work. After conclusion of the tests the doctor diagnoses Michael with empysema and early stage heart failure.