A 25-Year-Old Woman Complains of Chronic Constipation and Progressive Weight

Multiple Choice

A 25-year-old woman complains of chronic constipation and progressive weight gain over the past 6 months despite maintaining a pure vegan diet. Physical examination reveals a fatigued woman with brittle hair, face and eyelid puffiness, a symmetrically enlarged, non-tender thyroid gland, prolonged relaxation phase of deep tendon reflexes, and proximal muscle weakness in her lower extremities. Which set of the following results of thyroid function studies shown below would you expect in this patient? $$\begin{array} { l l l l } & \begin{array} { l } \text { Serum } \\\text { thyroxine } \\\left( \mathrm { T } _ { 4 } \right) \end{array} & \begin{array} { l } \text { Serum } \\\text { thyroid- } \\\text { stimulating } \\\text { hormone } \\\text { (TSH) }\end{array} & \begin{array} { l } 131 \mathrm { I } \\\text { (radioactive } \\\text { iodine) } \\\text { uptake }\end{array} \\\hline \text { A } & \text { Low } & \text { Low } & \text { Low } \\\mathrm { B } & \text { Low } & \text { High } & \text { Nomal } \\\mathrm { C } & \text { High } & \text { Low } & \text { Low } \\\mathrm { D } & \text { High } & \text { Low } & \text { High } \\\mathrm { E } & \text { Normal } & \text { Normal } & \text { Normal }\end{array}$$

A) $\text {Low}$ $\quad$$\quad$$\text {Low}$$\quad$ $\quad$$\text {Low}$
B) $\begin{array}{llcc} \text {Low } & \text { High } & \text { Normal }\\\end{array}$

C) $\begin{array}{llcc} \text { High } & \text {Low } & \text { Low } \\\end{array}$

D) $\text { High } \quad \text { Low } \quad \text { High }$
E) $\text { Normal } \quad \text { Normal } \quad \text { Normal }$