Rapid Review: Hypothyroidism

July 3, 2017
Reviewed By: Amy Rontal


  • Patient will be complaining of generalized weaknessfatiguefacial swellingconstipation, cold intolerance, and weight gain
  • PE will show periorbital edema, dry skin, and coarse brittle hair
  • Labs will show high TSH and low free T4antithyroid peroxidase, and antithyroglobulin autoantibodies
  • Most commonly caused by Hashimoto’s thyroiditis
  • Treatment is levothyroxine
  • Comments: Takes about 6 weeks to see treatment effects. Monitor TSH
  • Hashimoto’s: Risk factor for non-Hodgkin lymphoma

Sample Question: A 55-year-old woman presents to your office with complaints of fatigue, dry skin, constipation and weight gain. Physical exam results include a heart rate of 58 bpm and diminished deep tendon reflexes. Laboratory testing reveals an elevated TSH. Which of the following is the most appropriate next step in management? 

By Yehuda Wolf, MPA, PA-C

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