A 66-year-old woman with increasing physical and mental lethargy and weight gain
Abstract
CASE tudy Family Medicine and Community Health CASE Sytud A 66-year-old woman with increasing physical and mental lethargy and weight gain John Murtagh Case history • overweight (BMI=30 kg/m ) CORRESPONDING AUTHOR: A 66-year-old woman presented with a • pulse, 56/min and regular; BP, 130/70 John Murtagh 10-month history of gradually increasing mmHg; temperature, 36.3°C; respira- Emeritus Professor, Department of General Practice, Monash Uni- fatigue, lethargy, weight gain, constipation, tory rate, 12/min versity, Victoria 3165, Australia and difficulty coping with the cold winter. She • cold hands and feet, skin dry, coarse E-mail: john.murtagh@monash. feels like sitting by the fire and doing noth- and dry hair edu ing. She tends to sleep excessively. She also • reflexes poorly active with delayed complains of chest tightness and shortness of ankle jerk Funding: This research received no specific grant from any fund- breath on exertion, such as when she hurries • Folstein Mini-mental State Exami- ing agency in the public, com- to catch a bus. nation – 22 of 30 points mercial, or not-for-profit sectors. Her daughter, who accompanied her to the medical appointment, has noticed that Questions for the physician to Received 20 June 2014; Accepted 15 August 2014 her