Rosh Internal Medicine Boost Practice Exam

What is the most likely diagnosis for a woman presenting with weight gain, fatigue, and constipation, along with bradycardia?

1. Hyperparathyroidism

2. Hyperthyroidism

3. Hypoparathyroidism

4. Hypothyroidism

The correct answer is: Hypothyroidism

The clinical presentation outlined in the question suggests hypothyroidism as the most likely diagnosis. In cases of hypothyroidism, patients commonly experience symptoms such as weight gain, fatigue, constipation, and bradycardia. Weight gain is associated with the reduced metabolic rate caused by insufficient thyroid hormones, leading to an accumulation of weight. Fatigue is another hallmark symptom, often resulting from the body’s slower energy production. Constipation is typically due to decreased gastrointestinal motility, which can occur with low thyroid hormone levels. Bradycardia, or a slower heart rate, can also be a direct consequence of decreased thyroid hormone, affecting cardiac function and the overall metabolic rate. In contrast, hyperparathyroidism is generally characterized by hypercalcemia and may lead to symptoms like kidney stones, bone pain, and gastrointestinal issues, but not the described cluster of symptoms. Hyperthyroidism would present with weight loss rather than gain, along with symptoms like increased heart rate, anxiety, and heat intolerance. Hypoparathyroidism primarily affects calcium levels in the body and produces symptoms like muscle cramps and tingling sensations, which do not align with the symptoms provided in the question. Overall, the combination of weight gain, fatigue, constipation, and bradycardia aligns