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NBME 20 Answers

nbme20/Block 2/Question#26

A male newborn is found to have a decreased blood ...

Thyroid hormone-binding globulin deficiency

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 +1  upvote downvote
submitted by monoloco(49),

Decreased total, normal free (unbound) = Thyroid hormone-binding globulin deficiency

 +1  upvote downvote
submitted by whossayin(4),

why can't "organification defect in T3 and T4" be the answer?

sugaplum  I think if it was organification defect you wouldn't have a normal T4 level in the serum. +2  

 +1  upvote downvote
submitted by sugaplum(40),

This is apparently congenital thyroid binding globulin deficiency

"Thyroxine-binding globulin deficiency — Thyroxine-binding globulin (TBG) deficiency is characterized by low serum total T4 but normal free T4 and TSH; the diagnosis is confirmed by measuring TBG concentrations. These infants have normal thyroid function and do not require treatment." - uptodate *can't find in FA, maybe it is in there somewhere?