crista
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A 29-year-old woman with a history of irregular menses becomes amenorrheic. She had no problems conceiving
her first child at the age of 23, but she has been trying unsuccessfully to become pregnant for the past two
years. She also notes a weight gain of about 3 kg, increasing fatigue, puffy face and marked cold intolerance. A
complete blood count (CBC) reveals a Hb of 11.1 and an MCV of 90. Physical exam reveals a moderate-sized
diffuse enlargement of the thyroid gland. Which of the following thyroid profiles would most likely be seen in this
woman?
A. Low T3, low T4, high TSH
B. Low T3, low T4, low TSH
C. Low T3, high T4, low TSH
D. High T3, low T4, low TSH
E. High T3, high T4, low TSH
I supposed the ans. is B because it's a hypotyroidism secondary to child birth (like a Sheenen sdr.);the answer is A and i want to know why-may be bz the tyr. gland is diffuse incresed in volume and this meas a high TSH?
appreciate any imput.
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| rida
Forum Guru
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This is how it work, always remember, if hyperthyroidism, TSH decreased, and if hypo, its increased. In hypothyroidism, the hormones T3, and T4 are low (HYPO) so the pituitary will think that it needs to increase TSH to promote the synthesis of those hormones, so you will have increase amount of TSH, however, due to patient's condition, the hormones are not being synthesized, so they were remian low. Basically, Hyperthyroidism, low TSH, hi t3 and t4, and hypothyroidism, High TSH, lowt3 and t4. Another thing that helps me, remember these hormones are involved in metabolism, notice this patient's weight gain, meaning she must have low T3 and T4, as her food is not being metabolized, hence the weight gain, hope this helps.
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| mash
Forum Fanatic
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ans is A bcoz pt has hypothyroidism in which T3 n T4 r decreased
decrease in t3 n t4 leads to increase in TSH n TRH(*feedback mech)
Increase in TSH causes enlargement of thyroid.
amenorrhoea/ irreg periods/constipation/ wt gain/cold intolerance r features of hypothyroidism.
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| crista
Forum Guru
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thank you both.
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