A 54-year-old woman has fatigue, otherwise unremarkable history and exam with normal visual fields. Na low, TSH high, FT4 low. What is the diagnosis?
سؤال مجاني 4 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Primary hypothyroidism
High TSH with a low free T4 is primary hypothyroidism: the thyroid itself fails and the pituitary responds with more TSH. Mild hyponatraemia can occur in hypothyroidism. Subclinical hypothyroidism needs a normal T4, and central (secondary) hypothyroidism gives a low or normal TSH, not a high one. Normal visual fields also argue against a pituitary mass.
ليش كل خيار صح أو غلط
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A
ليش غلط
Free T4 may be normal in subclinical cases; here free T4 is low, so the hypothyroidism is overt.
✓ Thyroid disorders.pdf · p. 9 -
B
ليش غلط
Secondary or tertiary hypothyroidism has a low free T4 with a low TSH; this patient's TSH is high.
✓ Thyroid disorders.pdf · p. 8 -
C
ليش صح
In primary hypothyroidism the thyroid fails, T3/T4 fall and TSH rises in compensation: high TSH with low free T4.
✓ Thyroid disorders.pdf · p. 8 -
D
ليش غلط
In hyperthyroidism excess T3/T4 causes a compensatory decrease of TSH; this patient's TSH is high.
✓ Thyroid disorders.pdf · p. 4
- المصدر
- Thyroid disorders.pdf · p. 8
Thyroid disorders.pdf · p. 9 - المحاضرة
- Thyroid Disorders · Endocrinology · Module B
- ظهر في
- MED41 ♂ EOM B