A 67-year-old woman presents to clinic with a 3-month history of fatigue, weight gain, constipation, and cold intolerance. Her past medical history is significant for atrial fibrillation managed with warfarin and metoprolol. She reports no new medications, but mentions she started taking iodine-rich kelp supplements approximately 4 months ago for joint pain after reading about their health benefits online. Vital signs show heart rate 52 bpm, and laboratory studies reveal: TSH: 18 mIU/L (normal 0.5–5.0) Free T4: 0.6 ng/dL (normal 0.8–1.8) TPO antibodies: negative Thyroglobulin antibodies: negative Which of the following best explains this patient's thyroid dysfunction?

  1. A)Wolff-Chaikoff effect from excessive iodine intakeGABARITO
  2. B)Warfarin-induced inhibition of thyroid peroxidase
  3. C)Metoprolol-related suppression of TSH secretion
  4. D)Atrial fibrillation with resultant thyroid hormone consumption
  5. E)Acute autoimmune thyroiditis triggered by iodine supplementation

Explicação

The Wolff-Chaikoff effect is the physiologic phenomenon in which excess iodine paradoxically inhibits thyroid hormone synthesis and release, leading to hypothyroidism. This occurs because high iodine concentrations inhibit thyroid peroxidase and block coupling... Ver explicação completa e trilha adaptativa →

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