Back to basics
Enter the fetus
Labs, drugs and rock'n'roll
That's what's up in pregnancy
How low can you go?
100
This is the most common cause of thyroid dysfunction worldwide?
What is iodine deficiency?
100
This phenomenon is responsible for the NORMAL rise of basal levels of thyroid hormone in pregnancy.
What is the estrogen-mediated increase in TBG?
100
Lithium, a commonly used mood stabilizer, has this effect on thyroid function.
What is inhibitory?
100
Your 42 year old Type I diabetic with twins and NVP also has night sweats, palpitations and diarrhea. Her TSH is <0.01 and her FT4 is high at 9 weeks. These signs and tests may distinguish the cause.
What are goiter, exophthalmos, thyroid receptor antibodies?
100
Women with overt hypothyroidism are at risk for these pregnancy complications.
What are SAB, abruption, preterm birth, stillbirth.
200
This tropic hormone, produced by the hypothalamus, is necessary for normal thyroid function?
What is TRH?
200
This phenomenon is responsible for the NORMAL decrease in TSH in the late first trimester?
What is the hcg-mediated pituitary suppression?
200
This test is recommended when thyroid exam reveals a dominant nodule.
What is fine-needle aspiration biopsy?
200
Women with overt hyperthyroidism are at risk for these pregnancy complications.
What are preterm birth, low birth weight, preeclampsia, stillbirth?
200
Born in 1881, he had a short career in academic medicine before returning to work as a family physician in his hometown.
Who was Hakaru Hashimoto?
300
The nonpregnant thyroid takes up this much iodine on a daily basis.
What is 60-100 mcg?
300
Fetal T4 production is first noted at this gestational week.
What is the 14th week?
300
These antibodies are commonly found among women with thyroid disease.
What are TSIs, TBIIs and anti-TPO antibodies?
300
These are feared maternal and neonatal complications of the thionamides.
What are agranulocytosis and aplasia cutis?
300
The patient you saw for a preconception consult, on 100 mcg of daily levothyroxine for hypothyroidism, calls with a positive pregnancy test and says she feels a little “droopy.” This is your first move.
What is increase her dose by 1-2 pills per week, or to 125 mcg daily.
400
This is the rate-limiting step in synthesis of thyroid hormone. What is iodide trapping?
What is iodide trapping?
400
Of T4, TSH, iodine and TRH, this substance does NOT cross the placenta.
What is TSH?
400
Use of this anti-arrhythmic drug may be limited secondary to its effects on the fetal thyroid.
What is amiodarone?
400
These are the primary mechanisms of action of propylthiouracil.
What are inhibition of iodination of thyroglobulin synthesis and inhibition of conversion of T4 to T3?
400
More than half of reproductive-aged women with Graves disease report that their symptoms began during this period.
What is the postpartum period.
500
This thyroid hormone is derived in large part from peripheral conversion.
What is T3?
500
In areas of severe iodine deficiency, this condition has a prevalence of up to 15%.
What is endemic cretinism?
500
This is the MOST confusing test in all of thyroid medicine.
What is the T3 resin uptake?
500
These are signs of fetal thyrotoxicosis.
What are fetal tachycardia, goiter, IUGR, craniosynostosis?
500
You see a patient in your office (no preconception consult) with a history of hypothyroidism, currently untreated. Her TSH and her gestational age are the same – 12. She asks “Doctor, will my baby grow up to be a bright young MFM fellow at MGH like you?” This is your reply.
What is “It depends.”
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