Qarissya Aprily Putri R

1810312033
20D

introduction I’d like to present Mrs Laila

Patient’s age and A 55-year-old houswife
occupation
Presenting Who presented with excessive drowsiness, decresed oral intake,
symptom(s) and and complete inability to open her eyes for 3 days
duration
Associated symptoms She also complained of increased sensitivity to cold, dryness of
skin, increased hair loss, hoarseness of voice and easy fatigability
Past symptoms and She also had difficulty getting up from the squatting position,
duration combing her hair, and dressing
Past medical history There was no relevant past history
Family history She also had no family history of any major illnesses
Findings on Her detailed physical examination revealed periorbital puffiness
examination and dry, coarse skin with a lemon-yellow tinge, extreme
psychomotor retardation and only responded to simple motor
commands, complete bilateral ptosis was present, power in the
proximal muscle groups in both upper and lower limbs was
decreased
Investigation results I did a lab test which showed Lipid profile was deranged with
increased serum triglyceride and cholesterol levels. T3 level under
the normal range, so do the T4 level.
diagnosis So i thought she had hypothyroidism
treatment I gave her 100 ug of thyroxine daily
Outcome - what After one week of treatment, The patient dramatically improved.
happened She was discharged after 2 weeks of hospitalization in the same
treatment, and was advised regular monthly follow up

I’d like to present Mrs Laila 55-year-old housewife with complaints of excessive
drowsiness, decreased oral intake and complete inability to open her eyes for 3 days.
In the last three years, she also had difficulty getting up from the squatting position,
combing her hair and dressing. These difficulties were gradually progressive with no
diurnal variations or periodic fluctuations. She complained of increased sensitivity to
cold, dryness of skin, increased hair loss, hoarseness of voice and easy fatigability.
She had no history or family history of any major illnesses.

Her detailed physical examination revealed periorbital puffiness and dry, coarse skin
with a lemon-yellow tinge. She suffered from extreme psychomotor retardation and
only responded to simple motor commands. Complete bilateral ptosis was present
although cranial nerve function examination was normal with no facial abnormality.
Power in the proximal muscle groups in both upper and lower limbs was decreased
(3/5)
Her baseline investigations revealed hemoglobin level of 11 g/dl with normocytic,
normochromic picture on peripheral blood smear with normal serum levels of
ferritin, vitamin B12 and folic acid. Lipid profile was deranged with increased serum
triglyceride and cholesterol levels. T3 level serum under normal range, t4 level under
the normal range too. Further investigations revealed a state of primary
hypothyroidism

For the threatment we started on 100 µg of thyroxine daily. After one week of
treatment, the patient dramatically improved, with complete recovery of ptosis and
significant improvement in her consciousness level.The patient was discharged after
2 weeks of hospitalization on the same treatment, and was advised regular monthly
follow up.

a b
Rifqah Wardah Astarini
1810313043
18C

introduction I’d like to present mrs Ani

Patient’s age and A 47 year old teacher
occupation
Presenting symptoms Who presented with a six month history of chest
and duration pounding array and tired easily
Associated symptomps she also complained sweats easily and feeling hungry
quickly
Past medical history There was no relevant past history
Social history She was married of two daughter and lives in west
sumatera
Family history Her mother has a history of graves disease
Findings on examination On examination, her eyes seemed to buldge, lump on
the neck and tremor
Investigation results we found her TSH levels high and we did a thyroid scan
which showed hyperthyroid
diagnosis So we tought she had hyperthyroid
treatment We gave her propylthiouracil (PTU)
Outcome – what She responded to the treatment and the lump on her
happened neck got smaller after.

I’d like to present mrs Ani, A 47 year old teacher, Who presented with a six month
history of chest pounding array and tired easily. she also complained sweats easily
and feeling hungry quickly. There was no relevant past history. She was married of
two daughter and lives in west sumatera. Her mother has a history of graves disease.
On examination, her eyes seemed to buldge, lump on the neck and tremor. we did a
lab check, her TSH levels was high and we did a thyroid scan which showed
hyperthyroid. So we tought she had hyperthyroid. We gave her propylthiouracil
(PTU). She responded to the treatment and the lump on her neck got smaller.
 English Task
Case Presentation

Oleh

Qarissya Aprily Putri

(1810312033 / 20D)
Rifqah Wardah Astarini
(1810313043 / 18C)

Pendidikan Dokter
2019/2020