Scenario

A 39-year-old Chinese man, drug

representative, complained of excessive
sweating and hunger for past 2 months. He
has no medical problem before and living a
healthy life.
Since the past 2 weeks, he noted difficulty
in climbing up stairs.

1. What is the possible cause of his

presenting symptoms ?
Hyperthyroidism
Diabetes Mellitus
Anxiety with somatic symptoms

2. What other relevant history and

clinical features would you look
for ?
Signs and symptoms of hyperthyroidism
History : Any enlargement of the neck? Duration of symptoms? - Any family history
of graves disease? - Heat intolerance Weight loss despite increase oral intake
Signs
: Thyroid enlargement,
Ophthalmolpathy Excessive sweating,
Weakness, Tremor, Hyperreflexia , Weight
loss, Increase BO

 Diabetes Mellitus
History : Any family history of DM?
Polydipsia, Polyuria, Polyphagia,
Hypoglycemic Symptoms, ask about
other complications.
Signs : Obesity, muscle wasting due
to neuropathy,

3. What investigations would

you order for this patient ?
Thyroid Function Test
Oral Glucose Tolerance Test

4. How do you manage this

condition ?
According to the diagnosis
established.
According to the symptoms.