CAMLPR Evaluation And Interpretation Competency Practice Test

Hashimoto's disease presents with which pattern of TSH and FT4?

TSH markedly elevated with low FT4 and FT3 TSH suppressed with high FT4 Normal TSH with normal FT4 Elevated TSH with high FT4

Correct Answer:

TSH markedly elevated with low FT4 and FT3

Explanation:

Hashimoto's disease destroys thyroid tissue, leading to reduced thyroid hormone production. The pituitary senses the low hormones and elevates TSH in an attempt to stimulate the thyroid. So the common pattern is a markedly elevated TSH with low free T4 (and often low free T3). This is why the correct choice shows high TSH with low FT4. The other patterns point to different states: a hyperthyroid pattern would have suppressed TSH with high FT4, euthyroid would have normal TSH and FT4, and high TSH with high FT4 isn’t typical for Hashimoto’s.

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