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Subclinical hypothyroidism — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareSubclinical hypothyroidismUSMLE Step 3

A 68-year-old woman has TSH 6.1 mIU/L with normal free thyroxine on repeat testing. She feels well and has no goiter. She takes no amiodarone or lithium. Lipid profile is mildly elevated and hemoglobin is normal. Which of the following is the most appropriate at this time?

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

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Correct answer: E — Monitor thyroid function without starting treatment now

Mild asymptomatic subclinical hypothyroidism in an older adult is often monitored, especially when TSH is below 10 mIU/L.

Reference: American Thyroid Association hypothyroidism guideline: https://www.thyroid.org/