Case 33 - 46 yo M with fatigue

Question 1

Gathering information

Answer 1

SIG E CAPS
Effect on life/job performance
Cold intolerance, hair loss, weight gain

Question 2

Physical examination

Answer 2

Head and neck (inspect conjunctivae, mouth, throat, lymph nodes, thyroid gland)
CV exam (auscultation)
Pulmonary exam (auscultation)
Abdominal exam (auscultation, palpation, percussion)
Extremities (inspection, checked DTRs)

Question 3

Differential diagnosis

Answer 3

Depression (SIG E CAPS)
PTSD (nightmares, anhedonia, poor concentration, difficulty staying asleep)
Hypothyroidism (fatigue, cold intolerance, weight gain, hair loss)

Question 4

Differential diagnosis

Answer 4

Depression (SIG E CAPS)
PTSD (nightmares, anhedonia, poor concentration, difficulty staying asleep within three months of incident, negative mood)
Hypothyroidism (fatigue, cold intolerance, weight gain, hair loss)