A 23-year-old woman comes to the office for follow- up. She has a 5-year history of hypothyroidism and has been on a stable dose of levothyroxine for the past 3 years. She is now 4 weeks pregnant with her first child. Physical examination findings are noncontributory. Results of laboratory studies 2 months ago showed a serum thyroid- stimulating hormone (TSH) level of 2.9 mu/L (2.9 mu/L) and a free thyroxine level of 1.4 ng/dL (18.1 pmol/L). Which of the following is the most appropriate management?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Recheck her serum TSH level
Thyroxine requirements rise early in pregnancy: the sources say to increase the levothyroxine dose by 30–50% once pregnancy is confirmed and monitor TSH every 4 weeks in the first half, aiming for TSH <2.5 in the 1st trimester. Her last TSH (2.9) is already above that target, so simply continuing unchanged is wrong. Among the options, rechecking TSH is correct. Iodine and T3 measurement have no role.
ليش كل خيار صح أو غلط
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B
ليش غلط
In pregnancy, hypothyroidism is followed with TSH against trimester-specific goals, not with free T3.
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C
ليش صح
Women on levothyroxine need their dose raised 30-50% once pregnancy is confirmed, and TSH checked every 4 weeks in the first half (goal below 2.5 in the 1st trimester); her last TSH of 2.9 is above it.
✓ view-material.pdf · p. 124 -
D
ليش غلط
Not unchanged: for women already on levothyroxine the dose should be increased 30-50% as soon as pregnancy is confirmed, with close TSH monitoring.
✓ view-material.pdf · p. 124
- المصدر
- view-material.pdf · p. 124
- المحاضرة
- Thyroid Disorders · Endocrinology · Module B
- ظهر في
- Endo bank