1. Kate is a 30 year oldwoman who just delivered her second child two weeks ago. Two weeksafter her delivery, Kate comes to your office to be evaluated. Shestates she has been tired, weak, and has widespread joint andmuscle pain. Despite the mild weather, she notes that she is coldall the time, and that instead of losing her “baby weight” she hasactually gained about 15 pounds.

   Kate has delivered twohealthy children. She has no other medical history. It is herintention to breastfeed for at least the first 12 months. Shecontinues to take her prenatal vitamins, and plans on having anintrauterine device placed for contraception at her six week followup. She is a non-smoker, does not have a history of illicit druguse, and is currently abstaining from alcohol though she hasconsumed alcohol socially prior to her pregnancies.

   Her vital signs are asfollows: Height 5’4”, weight 165 lb, Heart rate slowed at 48 beatsper minute, blood pressure normal at 110/56, temperature normal at98.2℉.

   • What disease process do yoususpect is causing Kate’s symptoms? Name the disease and explainwhich symptoms, signs, or history information brought you to thatconclusion.
   • What other symptoms do yoususpect Kate may be experiencing? Are there any specific clinicalsigns you expect to find that have not yet been noted?
   • What type of laboratory workupwould you expect for Kate?