Question

A 32-year-old woman presents with palpitations, weight loss and heat intolerance. She has a diffuse goitre and eye signs. Blood tests show suppressed TSH and elevated free T₄ and T₃, consistent with Graves’ disease. What is the most appropriate initial medical management?

Accepted Answer

Start Carbimazole and a beta-blocker such as Propranolol for symptom control.

Answer

Start Levothyroxine replacement immediately.

Answer

Start long-term Prednisolone to suppress thyroid inflammation.

Answer

Advise no drug therapy and arrange urgent thyroidectomy.

Answer

Start radioiodine therapy as first-line in all cases.

Practice question

A 32-year-old woman presents with palpitations, weight loss and heat intolerance. She has a diffuse goitre and eye signs. Blood tests show suppressed TSH and elevated free T₄ and T₃, consistent with Graves’ disease. What is the most appropriate initial medical management?