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Which of the following is the most appropriate next step in management?
A. Continue Propylthiouracil (PTU) until delivery, then switch back to Methimazole.
B. Discontinue Propylthiouracil (PTU) and initiate Methimazole (MMI) for the remainder of the pregnancy.
C. Refer the patient for a subtotal thyroidectomy in the second trimester to avoid further medication exposure.
D. Taper off Propylthiouracil (PTU) completely, as thyroid function naturally normalizes in the second trimester.
E. Add Levothyroxine (T4) to her current regimen to prevent fetal hypothyroidism. | 79 | 0 | 0 | 0 | Loading... | |
A 28-year-old female presents to the antenatal clinic for a routine check-up at 14 weeks of gestation. She has a known history of Graves' disease. Upon discovering she was pregnant at 6 weeks gestation, her endocrinologist safely transitioned her to Propylthiouracil (PTU), and her symptoms of palpitations and heat intolerance have been well-controlled. Today, her vital signs are stable, and a thyroid panel shows her Free T4 is at the upper limit of the normal reference range. She asks about the plan for her thyroid medication for the remainder of her pregnancy. | 71 | 0 | 0 | 0 | Loading... | |
1. Young woman
2. Hyperthyroid symptoms:
Weight loss
Palpitations
Heat intolerance
Diarrhea
Tremor
3. Suppressed TSH
4. High free T4
5. Very low RAIU (<1%)
6. Undetectable thyroglobulin
7. No goiter / no ophthalmopathy
8. Weight-loss attempt + stress | 53 | 0 | 0 | 0 | Loading... | |
If a fine-needle aspiration of her cervical thyroid gland were hypothetically performed, which of the following histologic findings would most likely be observed? | 52 | 0 | 0 | 0 | Loading... | |
A 34-year-old female ICU nurse presents to the clinic complaining of chronic fatigue, palpitations, heat intolerance, and frequent loose stools for the past two months. She mentions she has been under extreme stress and is desperately trying to lose weight before her wedding. Her heart rate is 112 bpm and blood pressure is 140/80 mmHg. Physical examination reveals a thin, anxious woman with a fine tremor. Her thyroid gland is completely non-palpable, and there is no exophthalmos or pretibial myxedema.
Laboratory results:
TSH: < 0.01 mIU/L
Free T4: 4.5 ng/dL (Normal: 0.9 - 1.7 ng/dL)
Radioactive Iodine Uptake (RAIU) at 24 hours: <1% (Normal: 15-30%)
Serum Thyroglobulin: Undetectable
| 42 | 0 | 2 | 0 | Loading... | |
1. 28-year-old woman
2. Hyperthyroid symptoms:
Weight loss
Palpitations
Emotional lability/anxiety
Tachycardia
Warm moist skin
Fine tremor
3. Suppressed TSH (<0.01)
4. High free T4
5. High serum thyroglobulin
6. Very low radioactive iodine uptake (<1%)
7. Normal thyroid gland (no goiter, no nodules, no bruit)
8. Adnexal fullness / ovarian mass clue | 41 | 0 | 0 | 0 | Loading... | |
1. 28-year-old woman
2. Hyperthyroid symptoms:
Weight loss
Palpitations
Emotional lability/anxiety
Tachycardia
Warm moist skin
Fine tremor
3. Suppressed TSH (<0.01)
4. High free T4
5. High serum thyroglobulin
6. Very low radioactive iodine uptake (<1%)
7. Normal thyroid gland (no goiter, no nodules, no bruit)
8. Adnexal fullness / ovarian mass clue | 1 | 0 | 0 | 0 | Loading... | |
Which of the following is the most likely underlying etiology of this patient's condition? | 52 | 0 | 0 | 0 | Loading... | |
A 28-year-old woman is referred to the internal medicine clinic for a 3-month history of unexplained 7-kg weight loss, persistent palpitations, and emotional lability. She was recently evaluated in the emergency department for what she thought was a severe panic attack. She also reports occasional right lower quadrant abdominal discomfort, which she attributes to her menstrual cycle.
On physical examination, her blood pressure is 135/75 mmHg and her heart rate is 118 bpm. Her skin is warm and moist, and a fine tremor is noted in her outstretched hands. Neck examination reveals a supple, completely normal-sized thyroid gland with no palpable nodules, tenderness, or bruits. Deep palpation of the lower abdomen reveals mild right adnexal fullness.
Laboratory studies show:
TSH: <0.01 mIU/L (Normal: 0.4 - 4.0 mIU/L)
Free T4: 3.8 ng/dL (Normal: 0.9 - 1.7 ng/dL)
Serum Thyroglobulin: Markedly elevated
To investigate further, a radioactive iodine-123 (I-123) uptake scan of the anterior neck is performed, which reveals an uptake of <1% at 24 hours (Normal: 15-30%). | 50 | 0 | 0 | 0 | Loading... | |
1. Critically ill patient / ICU
2. Severe pneumonia → sepsis
3. No previous thyroid disease
4. Low free T3 with normal TSH and T4 initially
5. Low T3 + low T4 + low/normal TSH during severe illness
6. Transient TSH elevation during recovery phase
7. Abnormal thyroid function tests without intrinsic thyroid disease | 52 | 0 | 0 | 0 | Loading... | |
Which of the following is the most likely diagnosis for his dynamic thyroid laboratory findings? | 63 | 0 | 0 | 0 | Loading... | |
A 75-year-old male is brought to the Emergency Department from a nursing home with fever, productive cough, and altered mental status. On presentation, his respiratory rate is 32/min, blood pressure is 85/50 mmHg, and laboratory results show a BUN of 45 mg/dL. He is diagnosed with severe community-acquired pneumonia, with a calculated CURB-65 score of 4. He is immediately intubated, started on broad-spectrum antibiotics and vasopressors, and admitted to the ICU. Because he appears lethargic, a thyroid panel is ordered on Day 2, which reveals a normal TSH, normal free T4, and significantly low free T3. By Day 12 of his ICU stay, he remains critically ill with secondary sepsis; a repeat panel shows low TSH, low free T4, and persistently low free T3. After a prolonged course, he begins to improve. On Day 25, prior to transfer to a step-down unit, a third thyroid panel reveals a transiently elevated TSH (7.5 mIU/L) with normalizing free T4 and free T3 levels. The patient has no prior history of thyroid disease. | 89 | 0 | 0 | 0 | Loading... | |
تخفيض قناة الباطنة الـ MCQs and Cases
10 ليبيانا
للتواصل @Ducktor47 | 107 | 0 | 0 | 0 | Loading... | |
تخفيض قناة الباطنة الـ MCQs and Cases
10 ليبيانا
للتواصل @Ducktor47 | 86 | 0 | 0 | 0 | Loading... | |
كل من قارى طب فيه طقه وكل ما زاد قري زاد اطقطق 😂😂😂😂 | 20 | 0 | 0 | 1 | Loading... | |
في العالم كله
Dr : اختصار دكتور
في ليبيا
Dr : اختصار درويش | 18 | 0 | 0 | 0 | Loading... | |
القروب للي حاب ينضم ع الخاص @Ducktor47
لأن لو خليته عام الكل حينضم حتى من غير مايكون في رغبة حقيقية لكن ع الخاص اكيد تعب روحه ودز يبي يتدرب معانا | 226 | 0 | 0 | 4 | Loading... | |
ندير قروب تدريب سريري هيستوري
بحيث ناخذوا هيستوريات من بعض
هل الفكرة مناسبة؟ | 259 | 0 | 0 | 23 | Loading... | |
European Heart Journal, ehag100, https://doi.org/10.1093/eurheartj/ehag100
Published: 28 August 2026 | 279 | 0 | 0 | 0 | Loading... | |
 https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag100/8766302?login=false&fbclid=IwRlRTSAT-DalwZG9mBWZkaWQWUNXrcv2uQZrBlG-8u4Cbx3FcD91SYWV4dG4DYWVtAjExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkAAR44vcIclVNZnG6MO9p6p1L91lkZrQId6cGRDt1cEjPFvddUoMy18l4qACheBg_aem_89DImmfxfsrN79eQVAOZZw | 257 | 0 | 0 | 0 | Loading... |
