A 54 year old female has a history of lymphoma

Question Number 0834
A 54 year old female has a history of lymphoma. One of the treatments that had been employed was radiation to her neck. Much later, over a period of time, she starts to notice weakness and fatigue. She begins to notice that she no longer can take her evening walks, both because of her fatigue and she no longer likes the night air. She complains of constipation. She starts to put on some weight. On physical examination her heart rate is 65 and her blood pressure is 120/80. She has a slow return of her Achilles tendon reflex. Her skin is dry, somewhat swollen, and has a yellowish hue. Her laboratory results show a MCV of 100. Her thyroid is not palpable. Thyroid tests are done, but the results are pending. What is the most likely diagnosis?
a) myxedema
b) cretinism
c) Graves disease
d) Jod-Basedow phenomenon
e) Riedel's thyroiditis


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