Case Study 1
Mary is 38 yrs old mother of 2 who has come in complaining of tiredness. She has noticed a fine tremor and has been having trouble hanging out the washing due to fatigue. She is feeling anxious and has had some panic attacks, which are new for her.
Her weight has dropped 5 Kg without trying and she has been having hot flushes.
Her periods have become irregular.
On examination she has BP 130/60, pulse 95 and regular
She has a fine tremor and her reflexes are brisk.
There is no abnormality in the examination of her neck.
You consider ordering some investigations.