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Graves Disease — RACP Paediatrics MCQ

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ModerateEndocrinologyGraves DiseaseRACP Paediatrics

A 14-year-old girl presents with weight loss, tremor, tachycardia, heat intolerance, and a diffuse goitre. TSH is suppressed and free T4 is elevated. TSH receptor antibodies are positive. What is the first-line treatment?

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Correct answer: C — Antithyroid medication (carbimazole or propylthiouracil)

Graves disease is the most common cause of hyperthyroidism in children. First-line treatment is antithyroid medication (carbimazole in Australia). Definitive treatment (RAI or surgery) is considered if medical therapy fails, significant side effects occur, or after adequate trial (typically 18-24 months). Beta-blockers (propranolol) provide symptomatic relief.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Hyperthyroidism