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Quick Scroll hypothyroidism 04.26.08 (2 months ago) #1
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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Quick Scroll 04.26.08 (2 months ago) #2
d. do T4
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Quick Scroll 04.26.08 (2 months ago) #3
Dr H2O why you want to do T4 I thought FNB because Tsh is very high. Are you trying to differniate between primary and secondry cause of Hypothyrodism or hyper...... thank you
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Quick Scroll 04.26.08 (2 months ago) #4
Q is ---whats ur next step.
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Quick Scroll 04.26.08 (2 months ago) #5
Q is ---whats ur next step.
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Quick Scroll 04.26.08 (2 months ago) #6
Thanki you so much Dr H2O
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Quick Scroll 04.26.08 (2 months ago) #7
I think the most reasonable next step is US(ultrasound) followed by needle aspiration cytology.

This patient has irregular gland and we need to confirm first the presence ofa Nodule using US and then r/o possible malignancy by needle aspirat
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Quick Scroll 04.27.08 (2 months ago) #8
agree
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Quick Scroll 04.27.08 (2 months ago) #9
agree 100% with rk1972. Have a look at the algorithm in TN about thyroid management. Next step=US.
T4 will obviously be low, and is of no use.
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Quick Scroll 05.09.08 (2 months ago) #10
US agree
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