Thyroid Disorders

Which of the following is not a common effect of thyroid hormone deficiency?

• Dry hair

• Weight gain

• Diarrhea

• Fatigue

T/F: Subclinical hypothyroidism is characterized by normal TSH values and elevated T₃ and T₄ levels.

• True

• False

KC is a 22 YOF (wt110 lbs) recently diagnosed with hypothyroidism. Which of the following is the most appropriate starting dose of levothyroxine?

• 112 mcg daily

• 110 mcg daily

• 50 mcg daily

• 75 mcg daily

MG is a 44 YOF recently diagnosed with hypothyroidism. She was started on levothyroxine 88 mcg daily 4 weeks ago. Current meds: Wegovy 1.7 mg weekly, amlodipine 5 mg daily, multivitamin once daily, albuterol 90 mcg 2 puffs q4-6 prn, and Advair HFA 2 inhalations twice daily. What is the most appropriate recommendation at this time?

• Switch from levothyroxine to PTU 300 mg daily

• Switch to a different weight loss medication, such as Orlistat

• Separate administration of levothyroxine by 1-2 hours before taking your multivitamin

• Take levothyroxine at the same time as your other medications for increased absorption

SH is a 52 YOF (64 kg) presenting to your clinic complaining of fatigue, weight gain, and dry brittle hair over the past few months. She states there haven't been any recent changes to her lifestyle. Lab values: A1c 6.2%, eGFR 88 mL/min, TSH: 7.2 mIU/L (normal 0.4-4), T₃ 70 ng/dL (normal 80-180). What is the most appropriate medication to start?

• Propranolol 10 mg daily

• Levothyroxine 100 mcg daily

• PTU 300 mg daily

• Methimazole 30 mg daily

All of the following medications prevent peripheral conversion of T4 to T3 except

• Propranolol

• Methimazole

• Nadolol

• Propylthiouracil

T/F: Propylthiouracil is the preferred treatment of hyperthyroidism during the first trimester of pregnancy as methimazole increases risk of fetal abnormalities.

• True

• False

AI is a 34 YOF with a PMH significant for HTN, T2MD, and aFib who was recently diagnosed with hypothyroidism. Current medications include amlodipine, apixaban, amiodarone, pioglitazone, and metformin. Which of her medications could have contributed to hypothyroidism?

• Apixaban

• Amiodarone

• Pioglitazone

• Metformin

One of your providers reaches out to you regarding a patient they started on levothyroxine 2 weeks ago. The provider asks you the best time to measure the patient's TSH response. What is the best response?

• ASAP

• 4 weeks

• 6 weeks

• 8 weeks

T/F: Women are at a higher risk of developing hyperthyroidism.

• True

• False