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Chapter 62. Thyroid Disorders

BS is a 36-year-old woman who presents to her doctor with symptoms of anxiety, sleep disturbances, and recent weight loss. Her doctor suspects hyperthyroidism. Which of the following lab results would be consistent with overt hyperthyroidism?

a. Increased TSH, increased thyroid hormones

b. Decreased TSH, increased thyroid hormones

c. Increased TSH, decreased thyroid hormones

d. Decreased TSH, decreased thyroid hormones

Answer b is correct. Hyperthyroidism increased thyroid hormones that then decrease the amount of TSH needed by the thyroid gland.

Answer a is incorrect. Hyperthyroidism occurs when excess thyroid hormones are circulating in the body. As a result of the negative feedback system, increased concentrations of thyroid hormones will suppress the production of TSH so TSH levels will be decreased in hyperthyroidism.

Answer c is incorrect. Thyroid hormones are elevated in hyperthyroidism while TSH is suppressed. These lab results (increased TSH and decreased thyroid hormones) are typically found in hypothyroidism.

Answer d is incorrect. Thyroid hormones will be elevated in hyperthyroidism. TSH concentrations will be decreased.

MM is a pregnant 27-year-old woman who has just been diagnosed with hyperthyroidism. Which symptoms might MM be experiencing due to her diagnosis?

a. Bradycardia and cold intolerance

b. Tachycardia and heat intolerance

c. Depression and cognition difficulties

d. Weight gain and constipation

Answer b is correct. Tachycardia will occur due to increased adrenergic activity due to excess thyroid hormones. Heat intolerance and sweating are other common symptoms of hyperthyroidism due to increased metabolism.

Answer a is incorrect. Bradycardia and cold intolerance are typical symptoms of hypothyroidism.

Answer c is incorrect. Depression and cognition difficulties are typical symptoms of hypothyroidism.

Answer d is incorrect. Weight gain and constipation may occur due to her pregnancy but are more typical symptoms of hypothyroidism. Patients with hyperthyroidism may be more likely to experience frequent stools and weight loss instead.

MM is currently in first trimester of her pregnancy, but her doctor consults you for treatment options for hyperthyroidism throughout MM’s pregnancy. Select all that apply.

a. Surgery

b. Radioactive iodine

c. Methimazole

d. Propylthiouracil

Answer d is correct. Propylthiouracil is the preferred treatment for hyperthyroidism in the first ...

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