04 Jun Case Studies
Question
Mrs. Beacon, an 80-year-old female, is brought to the emergency room with recent onset of stupor. Her family reports that she has been complaining of fatigue and has been going downhill for some time with progressive withdrawal and somewhat paranoid behavior.
Diagnosis:
She was initially diagnosed with possible stroke because of lateralizing neurological signs. Later, hypothyroidism and early myxedema coma was diagnosed.
Presenting signs/symptoms:
Hyporeflexia on right side (could be from previous stroke), heart rate was 55, temperature 96°F, skin was dry, her hair was thinning and she had continued stupor. The ECG showed a sinus bradycardia and low voltage.
Relevant lab values (assume all other lab values are normal): Urinalysis revealed urinary tract infection, T3 and T4 normal, TSH elevated
Relevant diagnostic tests: Chest x-ray shows enlarged heart.
In your review of this case, please address the following questions. Please include at least 5 research articles and/or Web citations as references.
1. What are the etiology and risk factors associated with this case?
2. What is the pathophysiological basis for the signs/symptoms that are seen in this case?
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