41 year old man with weight loss and palpitations

Review of Systems

General: He reports a 10-kg weight loss over the previous 2 months despite an increase in appetite. No increased thirst. He says he feels hot most of the time but has not had a fever, chills, or night sweats.

Skin: No rash or other skin changes.

HEENT: His eyes feel gritty and he can spend no more than half an hour working on the computer. No blurry or double vision. No sore throat or neck pain.

Pulmonary: He complains of shortness of breath during mild exertion which was never present before. No cough.

Cardiovascular: Says he has palpitations whereby he feels as though his heart is racing even during mild exercise, and he has had to stop exercising. No chest pain or discomfort at rest or during exercise.

Gastrointestinal: He reports increased stool frequency with semi-formed stools 2 to 3 times per day. Stools are normal color, no blood noted. He denies abdominal pain, nausea, or vomiting.

Genitourinary: No difficulty urinating, no increase in frequency or volume or urination, no blood in urine.

Musculoskeletal: He reports cramps in his calves at night which he thinks have significantly reduced his exercise performance. No pain or swelling in bones or joints.

Neurologic: He feels his muscles are generally slightly weaker for the last 2 weeks, but weakness is nonfocal.

Psychiatric: He complains of being irritable and restless and unable to concentrate at work. He feels depressed although he is concerned about his current symptoms.

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