Uworld hashimoto q

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tasar1898

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Hey everyone , I just did a block in uworld and there was a q about hashimoto's with OBVIOUS signs of hypothyroidism that you had to pick the t4/t3/tsh values . Obviously I picked low t4/high tsh , and thought to look for reduced t3 too but it wasnt a choice , only normal . So anyway I picked that and it was correct .. The explanation said that t3 may be normal early in disease due to some compensation which makes sense. What doesnt make sense is why the patient had signs of hypothyroidism ?? Shouldnt the symptoms begin after t3 levels fall too , since T3 is the most active hormone anyway??

QID is : 983 [ 702836] ( dont know if it's useful for anythin..)

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Hey everyone , I just did a block in uworld and there was a q about hashimoto's with OBVIOUS signs of hypothyroidism that you had to pick the t4/t3/tsh values . Obviously I picked low t4/high tsh , and thought to look for reduced t3 too but it wasnt a choice , only normal . So anyway I picked that and it was correct .. The explanation said that t3 may be normal early in disease due to some compensation which makes sense. What doesnt make sense is why the patient had signs of hypothyroidism ?? Shouldnt the symptoms begin after t3 levels fall too , since T3 is the most active hormone anyway??

QID is : 983 [ 702836] ( dont know if it's useful for anythin..)

Free T4 is considered most significant. The learning objective is not to fall victim to every single thing in medicine having to fit through a certain shaped hole. Because most of the time things aren't what you've imagined. Then eventually if things are very textbook it's actually the surprise. And tangentially, you can have aldosterone derangement with bicarb, sodium and potassium all normal; that's on the USMLE; know the classic patterns, but don't insist on everything going through a certain hole. It's good advice.
 
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