A man feeling persistently sad and hopeless for two years with an unremarkable physical exam should undergo which diagnostic test?

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In the scenario presented, the individual is experiencing a prolonged period of sadness and hopelessness, which are hallmark symptoms of major depressive disorder. Given the duration of two years, it becomes important to rule out any underlying medical conditions that could be contributing to these psychological symptoms. This is where diagnostic testing becomes relevant.

Blood analysis is crucial in this context, as it can help identify several potential contributing factors to depression. Specifically, tests can assess thyroid function (e.g., TSH and free T4 levels), which is essential because hypothyroidism can manifest with depressive symptoms. Additionally, a complete blood count (CBC) can help detect anemia or other systemic illnesses, and vitamin levels (such as vitamin D and B12) may also be evaluated for deficiencies that can influence mood.

The other diagnostic tests listed would be less relevant in this situation. For example, thyroid ultrasonography is used to assess structural abnormalities of the thyroid gland, which does not directly evaluate function or confirm a diagnosis related to mood disorders. Polysomnography is typically used to diagnose sleep disorders, which, while they can be related to depression, are not the first line of evaluation for persistent sadness. Brain magnetic resonance imaging (MRI) is mainly used to evaluate structural brain abnormalities, which

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