👨🏻‍⚕️A real case from the clinic

30-year-old male with chronic Obesity (BMI 31).
He has done random labs and it shows the following:

Labs:
• TSH 7.3
• Free T4 = 0.75 ng/dl [N 0.70 – 1.48]
• Free T3 = 3.04 pg/ml [N 1.88 – 3.18]
• HbA1C & lipid profile (normal)

What is this condition?
How would you manage it?

(based on your questions, I will post more information)

Follow-up

Not diagnosed previously with hypothyroidism
Not on any meds or supplement

Hx: unspecified symptoms (fatigue, Obesity, anxiety, insomnia, constipation)

FHx: 3 family members of hypothyroidism (1st degree relatives)

These labs are not the first time
TSH is always high like this

What would you do next?

Follow-up

TPO Abs result

What is the diagnosis?
What would you do?

Subclinical hypothyroidism

© UWorld

Regarding our case, we have many reasons to initiate replacement therapy (age + TSH range is moderately high + symptoms + TPO-Abs)

👨🏻‍⚕️A real case from the clinic (with changes)

A 47-year-old male with chronic history of DM, HTN & DLP

Medications:
- Metformin XR 750 mg OD
- Dapagliflozin 10 mg OD
- Gliclazide 30 mg OD
- Valsartan 160 mg OD
- Amlodipine 10 mg OD
- Bisoprolol 5 mg OD
- Rosuvastatin 20 mg OD
- Fenofibrate 145 mg OD

C/O few weeks hx of on/off feeling of hotness in his face
so he expose it to cold water to be relieved

What do you think that is?
And What is the most likely cause?

(write your answers below👇🏻)

✅ Flushing 🥵 (S/E of Amlodipine)

دورة تكنولوجيا السكري 2025

‏✨تعرف على:

‏🔺أحدث أنظمة مراقبة الجلوكوز المستمرة ومضخات الإنسولين.
‏🔺تعلم كيفية تحليل بيانات AGP بثقة وتحليل تقارير مضخات الإنسولين.
‏🔺تعلم أنماط هبوط وارتفاع السكر والمنحنيات ودلالاتها.
‏🔺ستتمكن من تطبيق أهداف الوقت في النطاق (TIR).
‏🔺أمثلة لحالات حقيقية وكيفية التعامل معها.
‏🔺فرصة للتفاعل في جلسة أسئلة وأجوبة مع خبراء تكنولوجيا السكري.

‏📅التاريخ: 2025/07/29
‏📍يوم الأربعاء
‏⏰ ⁦ 8:00 ⁩ - ⁦ 10:30 ⁩ مساءً
‏📲 أونلاين وستكون مسجلة ومتاحة بالموقع

‏✅يوجد شهادة حضور

‏للتسجيل عبر الرابط:

خصم 20% عند إدخال كود AB

https://vistamed.osarh.pro/lesson/4/tech

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A previously healthy 42-year-old man presented with a 20-day history of an expanding, asymptomatic rash on his trunk. The initial lesion had been a red spot on the patient’s left side. 10 days after that spot had first appeared, smaller lesions had developed elsewhere. The patient reported no viral prodrome. The skin examination — including the initial lesion that had appeared — is shown. What is the diagnosis?

ANSWER: ✅ Pityriasis rosea (P.rosea)

On the basis of the finding of a “herald” patch in the patient’s midaxillary line on the left side, a diagnosis of pityriasis rosea was made. Pityriasis rosea is a self-limiting disorder that typically affects children, adolescents, and young adults. The cause of pityriasis rosea remains unclear. It may be related to viral reactivation of human herpes virus 6 or 7.

© NEJM image challenge

Primary Prevention in Adults 30-79

🤯 You could start STATIN if PREVENT score is as low as 3 !!!

📌 LDL of 160 could justify starting of Tx!

🆕 2026 Dyslipidemia (DLP) AHA/ACC guideline

Managing dyslipidemia (DLP) in patients with diabetes (DM)

📌 Not only those above 40, but as low as 20-year-old if has risk enhancers!

🆕 2026 Dyslipidemia (DLP) AHA/ACC guideline