Quiz 5 Flashcards
A patient who is taking levothyroxine therapy and has achieved normal TSH levels continues to have subjective symptoms suggestive of mild hypothyroidism. What is the most appropriate next step?
Question 1 Answer
a.
Reduce the dose of levothyroxine
b.
Order TSH from a different lab
c.
Add oral iodine therapy to the management plan
d.
Investigate celiac disease
d.
Investigate celiac disease
What is the most common cause of hypothyroidism in North America?
Question 2 Answer
a.
Iodine deficiency
b.
Autoimmune thyroiditis
c.
Thyroid gland failure
d.
Pituitary TSH deficiency
b.
Autoimmune thyroiditis
A patient with Hashimoto’s thyroiditis decided to take a “drug holiday” from her levothyroxine therapy while trying to manage symptoms naturally on her own. She presents to your office with marked confusion. On palpation, her skin temperature is cold. What is the most appropriate next step?
Question 3 Answer
a.
Sauna treatment during today’s visit
b.
Recommend she resume levothyroxine therapy
c.
Review natural therapies she is taking to identify a potential cause for her symptoms
d.
Prompt referral to the emergency room
d.
Prompt referral to the emergency room
What lab results would most indicate subclinical hypothyroidism?
Question 4 Answer
a.
Normal TSH, high fT4
b.
Low TSH, high fT4
c.
High TSH, normal fT4
d.
High rT3, high fT4
c.
High TSH, normal fT4
A non-pregnant patient who is feeling well requests that you order a TSH to check their thyroid function “to make sure it’s functioning optimally”. What is the U.S. Preventive Services Task Force (USPSTF)’s recommendation for situation’s like this one?
Question 5 Answer
a.
Harms of overdiagnosis outweigh benefits of detecting true disease
b.
Benefits of detecting true disease outweigh the harms of overdiagnosis
c.
Current evidence is insufficient to assess the balance of benefits and harms
d.
The USPSTF has no documented considerations of situations like this one
c.
Current evidence is insufficient to assess the balance of benefits and harms
