Case Study Analysis: Differential Diagnosis in a 45-Year-Old Woman

This case study focuses on the differential diagnosis of a 45-year-old woman presenting with fatigue, thinning hair, and weight gain. The assignment explores potential diagnoses, primarily hypothyroidism and Type 2 diabetes mellitus, based on the patient's symptoms. It outlines necessary blood tests, including TSH, T4, and blood glucose levels, as well as routine examinations. The study highlights expected laboratory results and physical examination findings that support each diagnosis. Furthermore, the paper addresses the differential diagnosis of Type 2 Diabetes Mellitus, outlining expected symptoms. It also discusses strategies to prevent diagnostic errors, particularly in children, emphasizing teamwork, education, and error reporting systems. The assignment provides a comprehensive overview of the diagnostic process, supported by relevant references.

Running head: DIFFERENTIAL DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
Name of Student:
Name of University:
Author’s Note:

1DIFFERENTIAL DIAGNOSIS
Introduction
The main aim of the paper is to evaluate the case study of a 45 years old lady who has
been showing common symptom and on such source differential diagnosis can be made on the
basis of tests and physical examination.
From the case study which stated that a women who is of 45 years old represent the
symptom of feeling tried, thinning hair and weight gain. All such symptoms was established six
months ago and no improvement or worsening in her health have been noticed since onset of
symptom. From the above stated symptoms, it can be anticipated that she might have
hypothyroidism as she has the symptoms of weight gain and thinning of hair (Dunn & Turner,
2016). However, focusing on the symptoms of feeling tried and recent weight gain she has the
potentialities of Type 2 diabetes mellitus. Other diagnosis on the basis of symptoms can be made
of seasonal depression, premenstrual syndrome, depression, even cardiovascular illness or drug
allergy. Hence, differential diagnosis of hypothyroidism and Type 2 Diabetes Mellitus can be
generated.
In order to support the differential diagnosis, different blood test which involves TSH
test, T4 test and Blood glucose level (fasting) test will be done. Apart from such necessary test
she is be asked to undergo routine examination which will test the metabolism and functioning of
the body. Such test will include total RBC count, total WBC count, and CRP, Creatinine,
haemoglobin, ESR, haematocrit and iron test. Expected laboratory test are, abnormal high level
of TSH above 5mU/L and low free T4 and it will indicate that the patient is having
hypothyroidism (Ross, Cooper & Mulder, 2015). Other differential diagnosis that exist around
hypothyroidism is high serum antithyroid peroxidase antibody in blood. Further, to confirm the

2DIFFERENTIAL DIAGNOSIS
diagnosis there is no need to assess pituitary gland as blood test will itself confirm the prevalence
of hypothyroidism in the patients. The physical examination which has shown the symptom of
hair thinning and weight gain will support the diagnosis. However, if there is high blood glucose
level she might be the patient of diabetes mellitus which is supported by sign tiredness.
For differential diagnosis the expected symptom of Type 2 Diabetes Mellitus are as follows
(Brod,et al., 2018).
 Increased thirst
 Dry mouth
 Frequent urination
 Blurred vision
 Headaches
 Loss of consciousness
 Increased hunger
 Weight loss
 Slow healing of the sores or cuts
 Recent weight gain
 Erectile dysfunction
 Unconsciousness
Most of the above stated symptoms can be expected to be seen in the children as for the
adult. However, the symptom of the erectile dysfunction are not noticed in the children.
In order to prevent the diagnostic error in children there is the need for collaborative
work by the clinical staffs who are involved in diagnosis of the disease. The strategies by this can

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be accomplished are first, facilitate better teamwork among the staffs, patients and family.
Second better education and learning should be provided to paediatrics nurse and lab technician
to make accurate test to prevent misdiagnosis (Singh et al., 2017). Third, a system must be
implemented to identify the diagnosis error and must include step to prevent and correct it.
Fourth, Healthcare executive involve in care of children, must encourage voluntary reporting of
the error in diagnosis. Effort should be made to check the effectiveness of the reporting program.

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Reference
Brod, M., Højbjerre, L., Pfeiffer, K. M., Sayner, R., Meincke, H. H., & Patrick, D. L. (2018).
Development of the weight-related sign and symptom measure. Journal of patient-
reported outcomes, 2(1), 17.
Dunn, D., & Turner, C. (2016). Hypothyroidism in women. Nursing for women's health, 20(1),
93-98.
Ross, D., Cooper, D., & Mulder, J. (2015). Diagnosis of and screening for hypothyroidism in
nonpregnant adults. UpToDate, Waltham, MA.
Singh, H., Schiff, G. D., Graber, M. L., Onakpoya, I., & Thompson, M. J. (2017). The global
burden of diagnostic errors in primary care. BMJ Qual Saf, 26(6), 484-494.