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An 86-year-old woman is brought to the emergency department from her nursing home facility. She has been more fatigued and less communicative over the past 3 days. The patient's only complaint is generalized weakness. She has had no witnessed falls and no signs of trauma during this time frame. Her past medical history is significant for mild dementia, well-controlled hypertension, and hyperlipidemia. Her medications include hydrochlorothiazide, losartan, and simvastatin. Her temperature is 97.6°F (36.4°C), blood pressure is 133/83 mmHg, pulse is 120/min, respirations are 16/min, and oxygen saturation is 98% on room air. Neurologic exam is unremarkable. There are no signs of trauma upon inspection. An ECG is performed as seen in Figure A. A previous ECG performed 2 weeks ago demonstrated normal sinus rhythm. An initial CBC, troponin, and serum chemistry are within normal limits. A chest radiograph, urinalysis, lumbar puncture, and flu swab are negative for any source of infection. Which of the following is the best next step in management?
Thyroid-stimulating hormone (TSH)
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