01-14-2010, 03:46 PM
A 44-year-old woman requests thyroid testing. She has chronic fatigue, which she attributes to the stress of being a single mother and having two jobs. Her medical history is positive for depression which is now controlled. Her mother has hypothyroidism and her father has coronary artery disease. Her only medication is fluoxetine.
On physical examination, the blood pressure is 135/85 mm Hg, pulse rate 64/min, and BMI 26.1. Her thyroid gland is not enlarged but is firm in consistency. Her skin is dry. Her reflexes are normal.
Laboratory Studies
Complete blood count
normal
Basic metabolic panel
normal
Cholesterol
235 mg/dL (6.08 mmol/L)
Triglycerides
118 mg/dL (1.33 mmol/L)
HDL cholesterol
45 mg/dL (1.16 mmol/L)
LDL cholesterol
166 mg/dL (4.29 mmol/L)
Thyroid-stimulating hormone (TSH)
13 µU/mL (13 mU/L)
TSH (repeat 6 weeks later)
14 µU/mL (14 mU/L)
Free T4 (at time of 2nd TSH)
1.0 ng/dL (12.87 pmol/L)
Which of the following clinical benefits will she likely experience in response to starting thyroid hormone replacement therapy?
A Weight loss
B Reduced blood pressure
C Increased HDL cholesterol
D Decreased LDL cholesterol
E Increased lean body mass
On physical examination, the blood pressure is 135/85 mm Hg, pulse rate 64/min, and BMI 26.1. Her thyroid gland is not enlarged but is firm in consistency. Her skin is dry. Her reflexes are normal.
Laboratory Studies
Complete blood count
normal
Basic metabolic panel
normal
Cholesterol
235 mg/dL (6.08 mmol/L)
Triglycerides
118 mg/dL (1.33 mmol/L)
HDL cholesterol
45 mg/dL (1.16 mmol/L)
LDL cholesterol
166 mg/dL (4.29 mmol/L)
Thyroid-stimulating hormone (TSH)
13 µU/mL (13 mU/L)
TSH (repeat 6 weeks later)
14 µU/mL (14 mU/L)
Free T4 (at time of 2nd TSH)
1.0 ng/dL (12.87 pmol/L)
Which of the following clinical benefits will she likely experience in response to starting thyroid hormone replacement therapy?
A Weight loss
B Reduced blood pressure
C Increased HDL cholesterol
D Decreased LDL cholesterol
E Increased lean body mass