A patient has constipation, fatigue and dry skin. Serum T3 and T4 are low, with TSH 1.2 (normal 0.4–4). Sodium is low, morning cortisol is low-normal and prolactin is high. What is the most likely diagnosis?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Secondary hypothyroidism
Low T3 and T4 with a normal (inappropriately low) TSH points to secondary (central) hypothyroidism: the pituitary is not making enough TSH. High prolactin and a low-normal cortisol suggest a pituitary lesion (e.g. stalk compression by a macroadenoma). Hashimoto's is primary disease with a high TSH. Euthyroid sick syndrome happens in acute illness; this patient has a pituitary picture instead. Factitious thyrotoxicosis gives high hormones.
ليش كل خيار صح أو غلط
-
A
ليش غلط
In Hashimoto's the thyroid fails and TSH production rises; her TSH is normal at 1.2 despite low T3/T4, which points to the pituitary instead.
✓ 1• Hypothyroidism [Notes].pdf · p. 4 -
C
ليش غلط
Factitious thyrotoxicosis is a cause of thyrotoxicosis, where the T4 level is elevated; this patient has low T3 and T4.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 4 -
D
ليش صح
A low or normal TSH with low thyroid hormones is the pattern of secondary hypothyroidism (pituitary), whereas a high TSH marks primary disease.
✓ Thyroid disorders.pdf · p. 9
- المصدر
- Thyroid disorders.pdf · p. 9
1• Hypothyroidism [Notes].pdf · p. 3 - المحاضرة
- Thyroid Disorders · Endocrinology · Module B
- ظهر في
- MED42 Compre B