Differential Diagnosis
The patient's presentation is complex, with a mix of acute and chronic symptoms. The following differential diagnoses are organized into categories based on their likelihood and potential impact.
- Single Most Likely Diagnosis
- Hyperthyroidism: The combination of weight gain, fatigue, nausea, vomiting, tachycardia, and hoarse voice, along with elevated blood sugar and high platelet count, suggests hyperthyroidism. The high AMT (antimüllerian hormone) is not typically associated with hyperthyroidism, but the other symptoms and lab results align with this diagnosis.
- Other Likely Diagnoses
- Anxiety Disorder: The patient's symptoms, such as chest pain, shortness of breath, dizziness, and presyncope, could be related to an anxiety disorder, particularly given the absence of other clear explanations.
- Gastroesophageal Reflux Disease (GERD): The sharp pain in the upper left quadrant (ULQ) and constant nausea and vomiting spells could be indicative of GERD.
- Chronic Stress or Adrenal Insufficiency: The patient's symptoms, such as fatigue, weight gain, and nausea, could be related to chronic stress or adrenal insufficiency.
- Do Not Miss Diagnoses
- Pulmonary Embolism: Although the D-dimer is negative, pulmonary embolism is a potentially life-threatening condition that should not be missed. The patient's symptoms, such as chest pain and shortness of breath, warrant consideration of this diagnosis.
- Cardiac Arrhythmia: The EKG shows sinus tachycardia and a borderline long QTc interval, which could indicate a cardiac arrhythmia.
- Pheochromocytoma: The patient's symptoms, such as hypertension, tachycardia, and headaches, could be related to a pheochromocytoma, a rare but potentially life-threatening tumor.
- Rare Diagnoses
- Mediastinal Mass: The patient's symptoms, such as chest pain and hoarse voice, could be related to a mediastinal mass, although this is a rare diagnosis.
- Multiple Endocrine Neoplasia (MEN) Syndrome: The patient's symptoms, such as weight gain, fatigue, and nausea, could be related to MEN syndrome, a rare genetic disorder that affects multiple endocrine glands.