NBME Step 2 CK Form 6 Serum thyroid-stimulating hormone concentration (NBME Answers)

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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 4/Question#33 (reveal difficulty score)
A 30-year-old woman comes to the physician ...
Serum thyroid-stimulating hormone concentration 🔍 / 📺 / 🌳 / 📖
tags: pharm endo

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submitted by ∗yb_26(316)

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lithium can cause hypothyroidism by interfering with normal synthesis and release oh thyroid hormone

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submitted by ∗carolebaskin(109)

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At baseline:

Then,

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submitted by ∗step_prep7(71)

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Patient with bipolar disorder who was started on lithium and has experienced weight gain most consistent with a picture of lithium-induced hypothyroidism
Key idea: Patients on lithium should have regular TSH monitoring every 6-12 months regardless of symptoms
Key idea: Lithium is associated with hypothyroidism, nephrogenic diabetes insipidus, chronic kidney disease and hyperparathyroidism

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submitted by ∗drmohandes(193)

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I did not understand why you don't check renal function.

Doesn't lithium affect both thyroid and kidney? Also, she has no clinical signs of hypothyroidism, so I figured we need to check her renal function.

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sassy_vulpix She has weight gain & sleep disturbances (? not sure if this is current or before medication) +2

drmohandes True, that information could point at hypoT. +1

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