TY - CHAP M1 - Book, Section TI - Chapter 226. Goitrous Hypothyroidism A1 - Usatine, Richard P. A1 - Smith, Mindy A. A1 - Chumley, Heidi S. A1 - Mayeaux, E.J. PY - 2013 T2 - The Color Atlas of Family Medicine, 2e AB - A 55-year-old woman presented with a several-month history of fatigue and weight gain. She reported that she felt puffy and swollen. She had difficulty buttoning the top button of her blouse because her neck was so large, but she reported no neck pain. Review of systems was positive for constipation, dry skin, and cold intolerance. On physical examination, a large goiter was found (Figure 226-1). Laboratory testing revealed an elevated thyroid-stimulating hormone (TSH) and a low free thyroxine (FT4) level confirming hypothyroidism. The patient was started on levothyroxine. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=57685600 ER -