Endocrinology Q 7

A 25-year-old woman is evaluated for anterior neck pain, fatigue, exercise intolerance, excessive sweating, and tremors that began 6 weeks ago. Other than an upper respiratory infection 2 months ago, she has been healthy. Medical history is otherwise unremarkable, and she takes no medications.

On physical examination, pulse rate is 105/min. Other vital signs are normal. The patient's thyroid gland is tender to palpation and is without discrete nodules. No thyroid bruit is auscultated. Bilateral lid lag is noted, but there is no proptosis, conjunctival injection, or chemosis. There is a fine tremor of her outstretched hands. Deep tendon reflexes are brisk.

Laboratory studies show a serum thyroid-stimulating hormone (TSH) level less than 0.01 µU/mL (0.01 mU/L), a serum free thyroxine (T4) level of 2.8 ng/dL (36.1 pmol/L), and a serum total triiodothyronine (T3) level of 190 ng/dL (2.9 nmol/L). Urine pregnancy test is negative.

Which of the following is the most likely diagnosis?

A Graves disease

B Molar pregnancy

C Subacute thyroiditis

D Toxic multinodular goiter

Choose an Answer Above

Have your answer...click Next Page to see if you're right.

Powered ByCareerCast