]> 2026-07-31T11:51:56+00:00 WBR0222 0 en Anti-thyroid peroxidase antibodies measurement '''Incorrect''' : Though the option of measurement of antithyroid antibodies is appropriate; any patient with TSH more than 10 is started on levothyroxine irrespective of their disease status. Start her on levothyroxine '''Correct''' : Patient with TSH more than 10 is started on levothyroxine irrespective of their disease status. Thyroglobulin measurement '''Incorrect''' : Thyroglobulin measurement is inappropriate in the management of hypothyroidism. Thyroid ultrasound '''Incorrect''' : Thyroid ultrasound would be useful if there is thyroid enlargement is present in order to monitor any change in size and look for dominant nodule(>1cm). Patient examination is normal and hence won’t be appropriate next step. Primary Care Office 55 year old women came for a routine health check up and she was found to have abnormal lipid profile. Her TSH level is 11 µU/ml (normal is 0.35-5 µU/ml) and her free T4 is 1ng/dl (normal is 0.8-1.8 ng/dl). She is asymptomatic and taking no medications. Family history is positive for hypothyroidism in mother. Her two siblings are normal. She denies smoking, alcohol and drugs. Her menstrual cycles are normal. Examination is normal and CBC, metabolic profile and lipid profile are within normal limits. Which is best next step in this patient management? B Endocrine 2020-10-27T23:48:47Z 2459150.4922107 WBR0222