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NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 1/Question#11 (reveal difficulty score)
A 32-year-old woman comes to the physician ...
Thyroid-stimulating hormone ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: hypothyroid post_partum TSH pregnancy

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submitted by โˆ—sugaplum(487)

According to UTD Postpartum thyroiditis is similar clinically and pathogenetically to painless thyroiditis except that, by definition, it occurs in women within one year after parturition (or after spontaneous or induced abortion).

TSH makes sense because she is bradycardic and has poor concentration

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submitted by โˆ—carolebaskin(109)

Remember, thyroiditis also causes hyperlipidemia

Increased LDL receptors +/- triglycerides due to increased LPL activity

Post-partum + cholesterol + lethargy + boredom + sleep issues + memory = thyroid

Would also expect hypnatremia, weight gain

Postpartum thyroiditis usually hyperthyroid followed by hypothyroid

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tinylilron  I was thinking about her palpitations. I wonder if that could be caused by her hyperthyroid state before her hypothyroid state. +

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submitted by โˆ—step_prep7(71)
  • Difficulty of this question is trying to differentiate between normal stresses of being a new mother vs. hypothyroidism
  • Features that point to hypothyroidism vs. normal stress include elevated cholesterol levels, memory problems, and lethargy
  • Postpartum thyroiditis can present up to 1 year after giving birth and although it is a fairly rare disease in real life, it is often tested on these exams
  • Cortisol = Cushingโ€™s (gaining weight, hirsutism, etc.) or Adrenal insufficiency (hypotensive, hyperpigmented skin, craving salt, etc.)
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