Page 2 of 2: hypothyroidism

bloater · Credits: 1258 My Scrapbook

Surface irregularity tempts me to investigate further. I prefer thyroid sono first, and fine needle aspiration after then.

jamal57 · Credits: 143 My Scrapbook

hypothyroidism with enlargement of thyroid gl. suggest Hashimoto`s disease , all mentioned investigations will add little to diagnosis , so I think you start thyroxine . of benefit is to do thyroid antibodies , not mentioned

doctorkarim · Credits: 79257 My Scrapbook

d- do T4
Because the TSH test is the best screening test, your doctor will likely check TSH first and follow with a thyroid hormone test if needed. TSH tests also play an important role in managing hypothyroidism. They help your doctor determine the right dosage of medication, both initially and over time.
If TSH levels are above the reference range, the next step would be to measure total T4.

bloater · Credits: 1258 My Scrapbook

Dear Dr's. T4 is meaningless this time because this patient shows definite hypofunctioning Sx and sign. Whenever we see patients showing equivocal or suspicious symptomless functional thyroid diseases presentation, it is almost always enough to check TSH only. And if there is no mention of irregularity(surface irregularity ?), thyroid hormone replacement may be justified as a next step. There is no known hypofunctioning thyroid malignancy as you know.

studyhard · Credits: 166 My Scrapbook

I absolutely agree with Dr.karim. Doing a T4 level would be the next best step whenever the TSH is out of the reference range to decide on the dosage of hormone replacement and follow the levels to aid in follow up.

Serp · Credits: 273 My Scrapbook

US then FN biopsy

mikejonathan20055 · Credits: 3320 My Scrapbook

Sart HRT

28 year old lady has weight gain ,fatigue etc.(features suggestive of hypothyroidism )for the last 2 years. On examination there is irregular rubbery enlargement of thyroid. TSH is 9.1 what is your next step?

a. give her eltroxin----------------
b. do radio active iodine uptake scan
c. FNAC
d. do T4
e. USS

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