Wed24November0743AM 1
Is it true or false that a high free T4 and high TSH may be due to the following?
True / False
Early hypothyroidism Correct
TSH resistance Correct
Erratic thyroxine dosing Correct
TSH secreting pituitary tumour Correct
Subacute thyroiditis Incorrect answer selected
Explanation
High thyroxine (T4) and high thyroid-stimulating hormone (TSH) are suggestive of a pituitary TSH secreting tumour. It may also occur in association with non-compliance with therapy in primary hypothyroidism.
Early, or compensated, hypothyroidism can lead to high TSH and low normal T4.
Erratic thyroxine dosing may be a cause, for example, a hypothyroid patient who usually does not take their tablets and then decides to take them for a few days before clinic.
Subacute thyroiditis is not a cause. Usually there is initially high T4 and normal TSH as the gland is destroyed then TSH falls. Hypothyroidism can then sometimes occur.
Low T4 not TSH resistance is correct.
Pituitary microadenoma is an extremely rare cause.
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Average score: 67.23%
Times answered: 274