Today's Case A 53-year-old woman presents with difficulty falling asleep and excessive daytime sleepiness for the past 6 months. She had a well-woman examination approximately 8 months ago, which was significant for diet-controlled diabetes mellitus type II (DMII) and Graves’ disease status post radioiodine ablative therapy. The remainder of her examination and all laboratory tests, including hemoglobin A1c and thyroid stimulating hormone, were normal. She denied any other health changes since her recent physical. However, she reports that on most nights of the week, she struggles to initiate sleep, usually laying in bed for up to an hour and a half “tossing and turning.” Today's Reader Ryan O'Connell is a junior biology major at Loyola Marymount University. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj ⁠⁠⁠⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Dr. Raj on Twitter⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Dr. Raj on Instagram⁠⁠⁠⁠⁠⁠⁠⁠ Want more board review content? ⁠⁠⁠⁠⁠⁠⁠⁠USMLE Step 1 Ad-Free Bundle⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Crush Step 1⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Step 2 Secrets⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Beyond the Pearls⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠The Dr. Raj Podcast⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠Beyond the Pearls Premium⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠USMLE Step 3 Review⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠MedPrepTGo Step 1 Questions⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠MedPrepTGo Step 2 Questions⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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