Consider the following statements regarding 'Factitious Thyrotoxicosis': 1. Induced when patients consume excessive amounts of levothyroxine. 2. The exogenous levothyroxine suppresses secretion of pituitary TSH (thyroid-stimulating hormone). 3. Serum thyroglobulin level is elevated. 4. T4 : T3 ratio is high. Which of the statements given above are correct?
1, 2 and 4
Factitious thyrotoxicosis results from surreptitious excess levothyroxine ingestion (statement 1), which suppresses pituitary TSH via negative feedback (statement 2). Since it is exogenous hormone, endogenous thyroid production and thyroglobulin are suppressed, so serum thyroglobulin is characteristically LOW/undetectable (statement 3 is false), a key feature distinguishing it from thyroiditis. As levothyroxine is pure T4, the T4:T3 ratio is high (statement 4 true). Hence 1, 2 and 4 are correct.
Important Questions from Thyroid Disorders
- Which one of the following diseases is characterized by destructive lymphoid infiltration of the thyroid gland leading to fibrosis and enlargement of the thyroid gland with an increased risk of developing thyroid lymphoma?
With regards to treatment of thyrotoxicosis of Grave's disease, consider the following statements:
1. Propylthiouracil is suitable in breastfeeding patients.
2. Large goitre is an indication for thyroidectomy.
3. Radioiodine is recommended for management in pregnancy.
4. Agranulocytosis is a complication associated with carbimazole.
Which of the statements given above are correct?
With regard to management of hypothyroidism, consider the following statements:
1. Treatment is with levothyroxine replacement.
2. It is taken as a single daily dose.
3. Average dose is 1.6 $\mu$gm/kg/day.
4. Full dose per weight should be started in those with coronary artery disease.
Which of the statements given above are correct?
- Low serum thyroglobulin levels are seen in
- A 27-year lady underwent thyroidectomy for thyroid carcinoma. Post-operatively she started developing muscle cramps, perioral and peripheral paresthesia, and carpopedal spasm. Which one of the following interventions will be appropriate for this patient?
