John, the 28-year-old fitness enthusiast, accompanies his mother, 54 years old Linda, to the surgery department for her goiter treatment.
Linda had a 10-year history of an enlarged thyroid gland, which had grown gradually over the years. The swelling in her neck had reached a size of approximately 10 cm \times 8 cm, becoming multinodular in contour but remaining painless until three months ago. Recently, she began to experience pain, tenderness, and mild difficulty swallowing. The pain was dull at first but gradually intensified, prompting her to seek medical attention. In addition to these symptoms, she reported intolerance to cold and feeling fatigued easily, though she had no fever, chills, night sweats, weight loss, or skin rash.
Linda works as a high school teacher and lives a healthy lifestyle, avoiding alcohol, smoking, and recreational drugs. Her family history included hypertension in her father and ovarian cancer in her mother. Her vital signs were normal during her initial examination, but the large goiter warranted further investigation and treatment.
As they wait for her appointment, John decides to get a quick health checkup. He’s curious about his BMI. David, the medical assistant proceeded to measure his height and weight and Visual Acuity
John's height: 5'10" (178 cm)
John's weight: 220 lbs (100 kg)