STUDENT’S GUIDE

BLOK ENDOCRINE AND METABOLISM 2021/2022

SCENARIO 2
PALPITATION

A woman, 40 years old, came to the doctor with complaint of intermittent heart palpitations
since 1 month ago, got worse in the last week. This complaint was not affected by activity. When
this complaint appeared, the patient felt nauseous and vomits. The patient also complain shortness
of breath that was not affected by position worsens with activity. Headache (+), frequent sweating
(+), weight loss of 5 kg in the last 1 month, although the patient felt easily hungry. However, in
the last 3 days, the patient complained of decreased appetite, because the shortness of breath often
recurs, tired easily (+), and tremor, especially in the fingers. The patient denied having a previous
history of hypertension, heart disease, and diabetes mellitus.
On physical examination, the general condition appeared moderately ill, blood pressure
140/70 mmHg, pulse 120 x/minute, respiratory rate 24 x/minute, and temperature 37,0oC,
exophthalmic eyes, and thyroid enlargement (+). Investigations revealed TSH levels of 0.006
uIU/ml, T3 5.56 mg/dl, and T4 18.2 mg/dl. The patient was given PTU 3x200 mg a day and
propranolol 3x20 mg.
Discuss the scenario by 7-jumps!

PENDIDIKAN DOKTER 1
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH SURAKARTA