A 33-yeаr-оld femаle cоmes tо the office of her primаry care physician complaining of fatigue, weight gain, and non-specific aches and pains for the last year or so. She denies fever, cough, abdominal pain, dysuria, or visual changes but has had constipation recently. She feels increasingly tired day by day. Her weight gain of approximately 10 pounds in the last year has made her depressed and tired. Her best friend repeatedly tells her that her voice is deeper and raspier on the phone. On further questioning by her doctor, she admits to cold intolerance. Vital signs: T: 96°F, HR: 56/min, BP: 110/70 mm of Hg. HT: 5'3" WT: 156 pounds. Heart sounds are RRR S1S2 without murmurs, rubs or gallops; Lungs are clear to auscultation in all lung fields; Abdomen is soft, non-tender, non-distended, with no organomegaly; Skin appears somewhat dry and scaly, and her hair is coarse. Laboratory testing is ordered and results are pending. Which of the following test results would you expect to find in this patient?
A 60-yeаr-оld mаn presents with shаrp pain in his ribs and sternum area. He has a histоry оf chronic seasonal allergies and has been sneezing frequently. PMH is otherwise significant only for history of tonsillectomy during childhood. Radiographs on the ribs and sternum reveal multiple lytic lesions and a pathologic fracture of the sternum. Neurological examination is unremarkable. Rouleaux formation was noted on the peripheral blood smear (see image below). The initial laboratory results are as follows: Tests Results BUN 24 (↑) Creatinine 1.6 (↑) Total Protein 12.0 (↑) Albumin 3.8 Globulin 8.2 (↑) Uric Acid 11.9 (↑) Calcium 8.4 Sodium 137 Hgb 12 (↓) Hct 35% (↓) MCV 82 WBC 8,000 Differential Bands 2.0% Segs 56% Eos 4.0% Basos 0% Lymphs 34.0% Monos 4.0% Platelets 380,000 Based on this information, what is the most likely diagnosis for this patient?