Graves Disease — RACP Adult Medicine MCQ

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EasyEndocrinologyGraves DiseaseRACP Adult Medicine

A 35-year-old woman presents with weight loss, tremor, palpitations, and heat intolerance. She has diffuse goitre, lid lag, and bilateral proptosis. TSH is <0.01 mU/L, free T4 is 55 pmol/L, and free T3 is 18 pmol/L. TSH receptor antibody is positive. What is the most likely diagnosis?

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Correct answer: D — Graves disease

Diffuse goitre with thyrotoxicosis, ophthalmopathy (proptosis, lid lag), and positive TSH receptor antibody (TRAb) is diagnostic of Graves disease. It is the commonest cause of hyperthyroidism in young adults. Management options include antithyroid drugs (carbimazole), radioactive iodine, or thyroidectomy.

Reference: ESA – 2024 – Thyroid Guidelines; ETA 2018 Graves Guidelines