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EACH PATIENT - AN OPEN BOOK Interesting Clinical Cases

EACH PATIENT - AN OPEN BOOK Interesting Clinical Cases. Dr. R.V.S.N.Sarma., M.D., M.Sc., (Canada) 5 Jayanagar, Tiruvallur 602 001 Mobile 93805 21221 Visit us at : www.drsarma.in. Clinical Problem. Middle aged lady Obesity Depression What was wrong ?

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EACH PATIENT - AN OPEN BOOK Interesting Clinical Cases

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  1. EACH PATIENT - AN OPEN BOOKInteresting Clinical Cases Dr. R.V.S.N.Sarma., M.D., M.Sc., (Canada) 5 Jayanagar, Tiruvallur 602 001 Mobile 93805 21221 Visit us at : www.drsarma.in www.drsarma.in

  2. Clinical Problem • Middle aged lady • Obesity • Depression • What was wrong ? • How she was investigated ? • What was the outcome ? www.drsarma.in

  3. Clinical Presentation 48 year lady 80 kg weight Lack of interest Lethargic, Indolent MDD score high Clinically Hypothyroid Investigations TSH very high > 100 T3, T4 and FT4 very low LDL 171 mg TC 267 mg Eltroxin 50 – 300 mcg Atorvastatin 10 mg Summary of the evaluations www.drsarma.in

  4. Follow up 49 year lady 61.9 kg weight Normal and active Anaemia improved No depression signs Clinically Euthyroid Investigations TSH ↓ (over corrected) FT4 and FT3 not done LDL 85 mg TC 168 mg HB 12 g % ECG N – HR 88/mt ↓ Eltroxin to 200 mcg Stop Atorvastatin How is she today ? www.drsarma.in

  5. What are the messages ? • Hypothyroidism is an under current • Unless suspected we will sure miss it • Depression and hypothyroid are associated • Pregnant / Middle aged women and • Obese individuals need thyroid evaluation • ↑ in LDL and TC may predispose for IHD • Start low and Go slow, TSH for follow up www.drsarma.in

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