A 53-year-old woman presents with weight loss, increased appetite, sweating, palpitations, and preference for cold weather, hot, moist palms, and tremors. What is the best investigation for the clinical diagnosis of this patient?
Ans. A TSH levelsRef: CMDT 2019 page 1139This patient presents with classic signs and symptoms of hyperthyroidism. The increased Basal metabolic rate and calorigenesis explain the symptoms of the patient. These patients have highly suppressed TSH levels. The highlights of hyperthyroidism are:* Sweating, weight loss or gain, anxiety, palpitations, loose stools, heat intolerance, fatigue, menstrual irregularity.* Tachycardia; warm, moist skin; stare; tremor.* Graves disease: Majority have a palpable goiter (sometimes with bruit); ophthalmopathy.* Suppressed TSH in primary hyperthyroidism; usually increased T4 ,FT4 ,T3 ,FT3 .
TSH levels
Autoimmune panel
Plasma catecholamines
Plasma Cortisol
Endocrinology metabolism