Approach to hypothyroidism Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 48-year-old woman presents to the primary care office for evaluation of two months of constipation. She has increased her water intake but has not tried over-the-counter medications. She is feeling more fatigued than usual. Past medical history includes bipolar disorder, for which she takes lithium. and high blood pressure, for which she takes lisinopril. Temperature is 37.0°C (98.6°F), pulse is 62/min, respirations are 18/min, and blood pressure is 122/82 mmHg.  Exam reveals a 10 lb weight gain from three months prior. The skin on the elbows and knees appears dry and flakey. Laboratory testing reveals a TSH of 9.1 mIU/L (reference range: 0.5-5 mIU/L)  and serum-free T4 of 0.71 ng/dL (reference range: 0.9-2.3 ng/dL). Thyroid peroxidase antibodies and thyroglobulin antibodies are negative. Which of the following is the most likely cause of this patient’s condition?  

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