A 58-year-old man with a history of papillary thyroid cancer treated with total thyroidectomy 5 years ago is on levothyroxine suppression therapy. His current free T4 is 1.9 ng/dL (high-normal) and TSH is 0.05 mIU/L (suppressed). He now presents with new-onset atrial fibrillation and osteoporosis on DEXA scan. Which of the following best describes the relationship between his current management and these complications?
- A)Chronic TSH suppression with supraphysiologic free T4 increases risk of atrial fibrillation and accelerates bone lossGABARITO
- B)Levothyroxine monotherapy is insufficient; combination with T3 is needed
- C)Post-thyroidectomy hypothyroidism causes cardiac arrhythmias and bone disease
- D)Papillary thyroid cancer has metastasized to the heart and bones
- E)Age-related cardiovascular and skeletal changes unrelated to thyroid hormone levels
Explicação
TSH suppression therapy is used in thyroid cancer to inhibit TSH-driven growth of any remaining thyroid tissue, but chronic exposure to supraphysiologic free T4 levels carries risks including atrial fibrillation (increased myocardial excitability) and accelera... Ver explicação completa e trilha adaptativa →