Sara (34-year-old female) presented to the outpatient clinic…

Sara (34-year-old female) presented to the outpatient clinic with complaints of fatigue, and easy bruising over the past two months. She also noted that minor cuts on her hands seemed to heal more slowly than usual. The patient denied severe pain, joint swelling, or significant weight loss. Medical History: No significant past medical history. Non-smoker and consumes alcohol socially. Works as an office assistant with limited physical activity. No regular supplementation of vitamins or minerals. Dietary History: Meals consist mostly of processed foods, with minimal intake of fresh fruits and vegetables. Frequently skips breakfast and consumes a fast-food lunch. Drinks coffee and soda but rarely water or juices. Clinical Examination: Vitals: Within normal limits. Skin: Small petechial hemorrhages on the forearms and mild ecchymosis on the legs. Oral Exam: Mild gingival swelling with occasional bleeding upon probing. General Appearance: No signs of severe distress. Laboratory Findings: Vitamin C (plasma ascorbate): 0.3 mg/dL (normal range: 0.4–2.0 mg/dL). Hemoglobin and hematocrit: Within normal limits. Platelet count: Normal. Prothrombin time (PT): Normal. Other vitamins (e.g., B12, folate): Within normal limits. What is Sara’s most likely diagnosis?

Jane (52 year old female) presents to her primary physician…

Jane (52 year old female) presents to her primary physician after a 6-month history of unexplained weight loss (approximately 12 lbs), increased appetite, and fatigue. She describes episodes of palpitations, heat intolerance, and excessive sweating. She denies significant changes in bowel habits or vision problems. Past Medical History: Hypertension (controlled with lisinopril). No prior thyroid issues. Family History:Mother had a history of goiter, no known thyroid malignancies. Medications: Lisinopril 10 mg daily. Occasional ibuprofen for headaches. Social History:Non-smoker, moderate alcohol use. Works as an elementary school teacher. Physical Examination General: Thin, anxious-appearing woman. Vital Signs: BP: 140/85 mmHg HR: 105 bpm (irregular) Temp: 99.5°F RR: 18/min Neck: Palpable multinodular goiter, non-tender. Cardiovascular: Irregularly irregular rhythm, no murmurs. Neurological: Fine tremor in both hands. Dermatologic: Warm, moist skin. Eyes: No proptosis, no lid lag. Laboratory Findings Test Result Reference Range TSH