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Hypothyroidism overt — USMLE Step 3 MCQ

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EasyInternal Medicine (chronic management)Hypothyroidism overtUSMLE Step 3

A 52-year-old woman has fatigue, weight gain, constipation, dry skin, and cold intolerance. TSH is 28 mIU/L and free thyroxine is low. She has no coronary artery disease. Pulse is 58/min. Which of the following is the most appropriate next step in management?

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Reveal the answer and explanation

Correct answer: B — Start levothyroxine replacement

Overt primary hypothyroidism with elevated TSH and low free thyroxine is treated with levothyroxine.

Reference: American Thyroid Association Hypothyroidism Guidance