Assignment task: Respond to discussion: A forty-five-year-old female presents to the clinic with complaints of feeling tired, thinning hair, and weight gain. Patient reports that these symptoms started six months ago, and nothing improves or worsens the feelings.
Differential diagnosis for this patient is hypothyroidism, Hashimoto's disease, stress, and Cushing's syndrome to name the few. Clinical manifestations include "weight gain, cold intolerance, increased total and LDL cholesterol, reduction in myocardial contractility and heart rate, nonpitting edema, dry skin; coarse, fragile hair, fatigue, delayed relaxation phase of the deep tendon reflexes, hypoventilation seen with severe hypothyroidism, constipation, menstrual abnormalities, reduced fertility, and increased risk of miscarriage" (Stern et al., 2020, p. 337-338). Diagnostic tests that clinicians look for are TSH, T3, and T4 blood levels (Ross, 2022).
Patients with type II diabetes present with polyuria, polydipsia, nocturia, blurred vision, weight loss, and slow wound healing (Inzucchi & Lupsa, 2023). The symptoms would be the same for a child as for an adult. However, per Tillotson et al. (2023), "children with type 2 diabetes mellitus most often present during asymptomatic screening" (para. 10). Usually, clinicians discover the diagnosis of diabetes in children during routine physical exam due to risk factors or glycosuria was detected on urinalysis (Laffel & Svoren, 2023).
To prevent diagnostic error in children, healthcare providers should screen at the onset of puberty by obtaining hemoglobin A1c and fasting plasma glucose (Laffel & Svoren, 2023). It is important for parents to have their children fast for at least eight hours to provide the most accurate results. In addition, clinicians may repeat the screening test in three to six months or sooner if there is a high suspicion of the diagnosis or proceed to an oral glucose tolerance test (Laffel & Svoren, 2023).
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