WBR0672

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Author [[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Serge Korjian)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Pathology
Sub Category SubCategory::Endocrine
Prompt [[Prompt::A 42-year-old Korean woman, with no significant past medical history, presents to the physician's office with complaints of excessive fatigue and weight gain. Upon further questioning, the patient reports she has recent developed constipation, hair loss, and somnolence. Physical examination is remarkable for a palpable thyroid mass. Following appropriate work-up, the patient is found to have elevated TSH, low FT4, and elevated levels of anti-thyroid peroxidase antibodies (anti-TPO). Which of the following conditions is known to be associated with the patient's disease?]]
Answer A AnswerA::Non-Hodgkin's lymphoma
Answer A Explanation AnswerAExp::Non-Hodgkin's lymphoma (NHL) is associated with Hashimoto's thyroiditis.
Answer B AnswerB::Hodgkin's lymphoma
Answer B Explanation AnswerBExp::Hodgkin's lymphoma is not associated with Hashimoto's thyroiditis.
Answer C AnswerC::Acute myelogenous leukemia
Answer C Explanation AnswerCExp::Acute myelogenous leukemia (AML) is not associated with Hashimoto's thyroiditis.
Answer D AnswerD::Chronic myelogenous leukemia
Answer D Explanation AnswerDExp::Chronic myelogenous leukemia (CML) is not associated with Hashimoto's thyroiditis.
Answer E AnswerE::Chronic lymphocytic leukemia
Answer E Explanation AnswerEExp::Chronic lymphocytic leukemia (CLL) is not associated with Hashimoto's thyroiditis.
Right Answer RightAnswer::A
Explanation [[Explanation::The patient is presenting with symptoms and signs consistent with Hashimoto's thyroiditis. She reports excessive fatigue, sleepiness, weight gain, cold intolerance, hair loss, and constipation - all of which are symptoms of Hashimoto's thyroiditis. Furthermore, physical examination confirms a thyroid pathology; and work-up makes the diagnosis of Hashimoto's thyroiditis most likely due to the presence of anti-TPO (positive in 90% of Hashimoto's thyroiditis cases). Hashimoto's thyroiditis is known to be associated with Non-Hodgkin's lymphoma (NHL).

Educational Objective: Hashimoto's thyroiditis is associated with Non-Hodgkin's lymphoma.
References: ]]

Approved Approved::No
Keyword WBRKeyword::Hashimoto's thyroiditis, WBRKeyword::Hypothyroidism, WBRKeyword::Autoimmune diseases, WBRKeyword::Non-odgkin's
Linked Question Linked::
Order in Linked Questions LinkedOrder::