A 26-year-old woman at 8 weeks' gestation presents with thyroid tenderness, heat intolerance, and palpitations. Vital signs show BP 138/82 mmHg, HR 108/min, RR 18/min, and temperature 37.2°C. TSH is suppressed at 0.1 mIU/L with elevated free T4 of 2.8 ng/dL. Thyroid ultrasound demonstrates diffuse enlargement without nodules. She denies recent iodine exposure. Because of her pregnancy timing, her physician prescribes a thionamide that inhibits both thyroid peroxidase and peripheral T4-to-T3 conversion. Which drug was most likely prescribed?

  1. A)Radioactive iodine
  2. B)Propranolol
  3. C)PropylthiouracilGABARITO
  4. D)Methimazole
  5. E)Potassium iodide

Explicação

Propylthiouracil is preferred during the first trimester because methimazole is teratogenic. PTU also inhibits peripheral 5 prime deiodinase, so it decreases conversion of T4 to T3 in addition to blocking thyroid hormone synthesis. Ver explicação completa e trilha adaptativa →

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