A 28-year-old woman at 8 weeks gestation presents for prenatal screening. Her TSH is 0.2 mIU/L (normal pregnancy range: 0.1–2.5) and free T4 is normal. She has no symptoms of thyroid dysfunction. She has a history of Graves disease treated with radioactive iodine 2 years ago. Which of the following is the most appropriate management?

  1. A)No thyroid medication needed; recheck TSH each trimesterGABARITO
  2. B)Measure thyroid-stimulating immunoglobulin (TSI) levels
  3. C)Start levothyroxine to normalize TSH to >1.0 mIU/L
  4. D)Start propranolol to prevent fetal tachycardia
  5. E)Repeat radioactive iodine treatment to prevent relapse

Explicação

After radioactive iodine ablation for Graves disease, most patients develop hypothyroidism and require levothyroxine. However, this patient currently has a low-normal TSH with normal free T4, indicating adequate thyroid function. No treatment is needed, but TS... Ver explicação completa e trilha adaptativa →

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