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Subclinical hypothyroidism — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareSubclinical hypothyroidismUSMLE Step 3

A 55-year-old woman returns after routine labs showed TSH 7.2 mIU/L with normal free thyroxine. She feels well, has no goiter, and takes no lithium or amiodarone. Repeat testing 8 weeks later is unchanged. Thyroid peroxidase antibody is negative. Which of the following would you recommend at the follow-up visit?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Monitor TSH periodically without levothyroxine

Mild asymptomatic subclinical hypothyroidism with TSH below 10 mIU/L can be monitored, especially without antibodies or pregnancy.

Reference: American Thyroid Association Hypothyroidism Guidance