American Board of Internal Medicine (ABIM) Certification Practice Exam

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What should practitioners monitor in patients with elevated cholesterol levels in relation to hypothyroidism?

Serum magnesium levels
TSH levels
Serum calcium levels
Serum vitamin D levels

The correct answer is: TSH levels

Monitoring TSH (Thyroid-Stimulating Hormone) levels in patients with elevated cholesterol levels is crucial due to the relationship between hypothyroidism and lipid metabolism. Hypothyroidism can lead to increased levels of cholesterol, particularly low-density lipoprotein (LDL) cholesterol, which can increase the risk of cardiovascular diseases. When hypothyroidism is present, the metabolism of lipids is affected, leading to an accumulation of cholesterol in the blood. TSH is a key marker for assessing thyroid function; elevated TSH levels indicate underactive thyroid function (hypothyroidism). By monitoring TSH levels, practitioners can determine if the thyroid is functioning adequately and assess the need for thyroid hormone replacement therapy, which can help in managing elevated cholesterol levels. This linkage between hypothyroidism and hyperlipidemia underscores the importance of thyroid assessment in patients who present with dyslipidemia. Treating the underlying hypothyroidism can often result in the normalization of cholesterol levels without the need for additional lipid-lowering medications.