Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions


Answer 7
  1. TSH level. The patient’s symptoms of depression, constipation, cold skin, and weakness are suggestive of hypothyroidism. The incidence of hypothyroidism is increased in Parkinson’s disease.12 Hypothyroidism should always be considered in the differential diagnosis of depression occurring with Parkinson’s disease and therefore TSH and free thyroxine should be obtained.11 Magnetic resonance imaging of the brain and psychological testing are not indicated in this patient. Referral to a psychiatrist could be considered if TSH is normal and if the patient meets criteria for depression.

    11. Okun MS, Watts RL. Depression associated with Parkinson’s disease: clinical features and treatment. Neurology 2002;58(4 Suppl 1):S63-70.

    12. Berger JR, Kelley RE. Thyroid function in Parkinson disease. Neurology 1981;31:93-5.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/31/08 • kkj