All good questions. I have a DELL XPS15 with a 4K screen and a 27" 4K Monitor and it works well for me. I typically run my Laptop at 1920 x1080 and 125% text size and the external monitor at 3840 x 2160 and 200%. I run TBC normal size Icons on my Quick Access Toolbars and Side Toolbars if using TBC on either the Laptop Screen or on the 4K Monitor
There is a trick here also - if you select your 4K Monitor as the Primary Screen and your Laptop as an Extended / Secondary Screen, then when the Laptop sizes things it does so based off the 4K Monitor vs the opposite if you have your Laptop screen as the Primary Monitor. This approach gives better sizing of everything in TBC (this is a Windows issue and nothing to do with TBC.
While when you make these changes to your Display Settings, it looks like it has introduced the new settings, there are some settings that don't take effect until you sign out of Windows and resign in again. This affects things like the [+] characters for expanding and shrinking Layer Groups etc. So always get your settings right and then Sign Out and Sign in again
This is what TBC looks like on my 4K Monitor

This is what TBC Looks like on my Laptop Screen

I find this very usable in this setup configuration.
I have a nvidia GeForce Graphics Card on my Laptop.
Remember however that when you split across two or three monitors that you are halving or thirding your graphics memory and if you use a docking station that can reduce it further still, so having multiple screens may be good for some things, when running TBC you may want more Graphics Memory and therefore running fewer screens and running direct from your laptop will give better performance than multiple screens and running through a Docking Station.
Hope this helps
Alan