q17 - guest1

[ArchivalUser]

A 58-year-old woman presents as an outpatient with lethargy, fatigue, and cold intolerance. Thyroid function testing reveals a free T4 of 0.5 (0.7 to 2.0) and a TSH of 0.1 (0.5 to 5). Which of the following is the best next diagnostic test
A.
Thyroid scan and uptake
B.
MRI of the pituitary
C.
Prolactin
D.
Thyroid autoantibodies
E.
T3

[ArchivalUser]

BB

[ArchivalUser]

bb

[ArchivalUser]

D?

[ArchivalUser]

The answer is: B

This patient presents with clinical manifestations of hypothyroidism with a low free T4. Secondary hypothyroidism is suggested by the low TSH. The diagnostic test of choice is a MRI of the pituitary for evaluation of a possible pituitary tumor