In lines 328–330, Gregor speculates about how his family and…

In lines 328–330, Gregor speculates about how his family and the chief clerk will react when they see him: “If they were shocked then it would no longer be Gregor’s responsibility and he could rest.” What “responsibility” is Gregor concerned about? Why would a shocked reaction free him from it?

A 42-year-old woman presents with complaints of fatigue, col…

A 42-year-old woman presents with complaints of fatigue, cold intolerance, constipation, weight gain, and dry skin over the past few months. She mentions that her periods have become heavier. On examination, her heart rate is 58 bpm, her skin is dry, and she has a mildly enlarged, non-tender thyroid. Her lab values are:Test                                  Result                           Reference RangeTSH                               7.9 µIU/mL                  0.4–4.0 µIU/mLFree T4                         0.5 ng/dL                      0.8–1.8 ng/dLAnti-TPO Ab                Positive                        Negative/Low Based on the clinical findings and labs, what is the most appropriate initial treatment for this patient?