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	<owl:Ontology rdf:about="https://www.wikidoc.org/index.php/Special:ExportRDF/WBR0213">
		<swivt:creationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2026-07-31T11:51:04+00:00</swivt:creationDate>
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	<swivt:Subject rdf:about="https://www.wikidoc.org/index.php/Special:URIResolver/WBR0213">
		<rdf:type rdf:resource="https://www.wikidoc.org/index.php/Special:URIResolver/Category-3AWBRQuestion"/>
		<rdf:type rdf:resource="https://www.wikidoc.org/index.php/Special:URIResolver/Category-3APages_using_duplicate_arguments_in_template_calls"/>
		<rdfs:label>WBR0213</rdfs:label>
		<rdfs:isDefinedBy rdf:resource="https://www.wikidoc.org/index.php/Special:ExportRDF/WBR0213"/>
		<swivt:page rdf:resource="https://www.wikidoc.org/index.php/WBR0213"/>
		<swivt:wikiNamespace rdf:datatype="http://www.w3.org/2001/XMLSchema#integer">0</swivt:wikiNamespace>
		<swivt:wikiPageContentLanguage rdf:datatype="http://www.w3.org/2001/XMLSchema#string">en</swivt:wikiPageContentLanguage>
		<property:AnswerA rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Primary hypothyroidism</property:AnswerA>
		<property:AnswerB rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Central hypothyroidism</property:AnswerB>
		<property:AnswerBExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect'''-Low T4 with normal TSH level can be seen in central hypothyroidism.</property:AnswerBExp>
		<property:AnswerC rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Subclinical hypothyroidism</property:AnswerC>
		<property:AnswerCExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect'''-Normal T3 and T4 with increased TSH level is seen in subclinical hypothyroidism.</property:AnswerCExp>
		<property:AnswerD rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Sick euthyroid syndrome</property:AnswerD>
		<property:AnswerDExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Correct'''-Any patient with acute and severe illness may have an abnormal thyroid function test.  This is sick euthyroid syndrome (low T3 syndrome), which is due to the caloric deprivation and increased cytokine levels during the period of illness.  The abnormality pattern is usually a low total or free T3 level with normal T4 and TSH levels, due to decrease in the peripheral conversion of T4 to T3.  Longer the duration of illness, T3 fall might be followed by fall in T4 and TSH levels.  On recovery from illness there might be a transient increase in TSH levels.  For this reason, a thyroid test is usually not performed in severely ill patients unless there is a strong indication, since these abnormalities can be misleading.</property:AnswerDExp>
		<property:AnswerE rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Reidels thyroiditis</property:AnswerE>
		<property:AnswerEExp rdf:datatype="http://www.w3.org/2001/XMLSchema#string">'''Incorrect'''-Reidels thyroiditis presents as primary hypothyroidism.</property:AnswerEExp>
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		<property:ExamType rdf:resource="&wiki;USMLE_Step_2_CK"/>
		<property:MainCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Internal medicine</property:MainCategory>
		<property:PageAuthor rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Vendhan Ramanujam</property:PageAuthor>
		<property:Page_has_default_form rdf:resource="&wiki;WBRQuestion"/>
		<property:Prompt rdf:datatype="http://www.w3.org/2001/XMLSchema#string">A 56 year old diabetic male is admitted to the coronary care unit with acute myocardial infarction complicated by cardiogenic shock.  His hospital course was complicated by acute renal failure.  His thyroid study came out as abnormal.  He does not have any previous history of thyroid disease.  Physical examination of the thyroid gland is found to be normal. Lab result of the thyroid study is as follows:&lt;br&gt;
Serum T3: 1.1 nmol/L (Normal 1.8 to 2.9 nmol/L)&lt;br&gt;
Serum T4: 8 microg/dL (Normal 5 to 12 microg/dL)&lt;br&gt;
The most likely diagnosis is</property:Prompt>
		<property:RightAnswer rdf:datatype="http://www.w3.org/2001/XMLSchema#string">D</property:RightAnswer>
		<property:SubCategory rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Endocrine</property:SubCategory>
		<swivt:wikiPageModificationDate rdf:datatype="http://www.w3.org/2001/XMLSchema#dateTime">2020-10-27T23:47:26Z</swivt:wikiPageModificationDate>
		<property:Modification_date-23aux rdf:datatype="http://www.w3.org/2001/XMLSchema#double">2459150.4912732</property:Modification_date-23aux>
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