A 29-year-old female who came to your office as a referral from her family doctor with a lab result of TSH of 0.001 and symptoms of tremor, excessive perspiration and intolerance to room temperature. You decide to order Free T3 and Free T4 and they came both elevated What is your next step?
سؤال مجاني 8 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Order Thyroid scan and uptake
Suppressed TSH with high free T3/T4 confirms primary hyperthyroidism, but the cause is unknown (no eye signs or goitre described). A radioiodine uptake scan distinguishes Graves (diffuse ↑), toxic nodule/MNG (focal/patchy) and thyroiditis/exogenous (low uptake), which decides treatment. Starting methimazole/PTU or surgery before knowing the cause is premature (e.g. thyroiditis needs no antithyroid drugs).
ليش كل خيار صح أو غلط
-
A
ليش غلط
The cause is not yet known. High uptake means new hormone synthesis (Graves, toxic goitre/adenoma); low uptake means release from inflamed or damaged tissue, so the uptake scan comes before choosing treatment.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 4 -
B
ليش غلط
Starting methimazole is premature: the cause is not yet known. Low uptake (e.g. subacute thyroiditis) means hormone is released from inflamed or destroyed tissue rather than newly made, whereas high uptake means new synthesis (Graves, toxic goitre, adenoma), so the uptake scan comes first.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 4 -
C
ليش صح
The radioactive iodine uptake scan is the first-line test when the cause of thyrotoxicosis is uncertain after the initial evaluation (TSH and free T3/T4).
✓ thyroid and parathyroid- Afnan.pdf · p. 21 -
D
ليش غلط
Surgery is reserved for very large goitres, allergy to antithyroid drugs or patient preference; only about 1% of hyperthyroid patients are operated on.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 5 -
E
ليش غلط
Tremor, sweating and heat intolerance with low TSH and high free T3/T4 are organic thyrotoxicosis; tremor is a recognised neurologic sign of hyperthyroidism, so this is not a psychiatric problem.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 4
- المصدر
- thyroid and parathyroid- Afnan.pdf · p. 21
Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 4 - المحاضرة
- Thyroid Disorders · Endocrinology · Module B
- ظهر في
- Endo bank