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Nbme1 birth complication q - quansar
#1
A 32-year-old woman comes to the physician because of lethargy and boredom since the birth of her son 5 months ago. She worries about her ability to care for him and has had frequent palpitations. She is unable to fall back asleep after nighttime feedings. She stopped breast-feeding 1 month ago. Her son is healthy, and growth and development are normal for his age. Her blood pressure is 122/80 mm Hg, pulse is 58/min, and respirations are 18/min. Physical examination shows no abnormalities. She remembers one out of three objects after 5 minutes. Her serum cholesterol level is 265 mg/dL. The most appropriate next step in diagnosis is measurement of which of the following serum levels?

A) Cortisol
B) Estrogen
C) Progesterone
D) Prolactin
E) Thyroid-stimulating hormone

explain please
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#2
hypothyroidism......TSH....eeeeeeee.....

raised serum cholesterol.....depression...lethergy...and bradycardia.....all suggestive
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#3
hypothyroidism [ post partumdue to lymphocytic thyroiditis ] can explain her low mood and elevated cholesterol at this young age. EEE
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#4
It is Option E. As zzetegn explained bang on, this is post-partum lymphocytic thyroiditis. Do a TSH; this is hypothyroidism (the patient is depressed, pulse is 58 [<60], and is lethargic, with a raised serum cholesterol).
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