A67-year-old woman has had fatigue, dry skin, brittle hair, swelling of the ankles, and cold intolerance for 1 year; she has gained 9 kg (20 lb) during this period. her pulse is 55/min, and blood pressure is 150/90 mm hg. she appears lethargic. examination shows dry skin and a nontender thyroid gland that is enlarged to two times its normal size. there is mild edema of the ankles bilaterally. the relaxation phase of the achilles reflex is greatly prolonged. which of the following is the most likely diagnosis? (a) chronic lymphocytic thyroiditis (hashimoto disease)(b) defect in thyroxine (t4) biosynthesis(c) graves disease(d) multinodular goiter(e) riedel thyroiditis(f) thyroid cyst(g) thyroid lymphoma(h) thyroiditis
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