Graves disease — RACP Paediatrics MCQ

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ModerateEndocrineGraves diseaseRACP Paediatrics

A 14-year-old girl presents with weight loss, tremor, heat intolerance, and palpitations. Examination reveals a diffuse goitre, exophthalmos, and lid lag. TSH is <0.01 mU/L, free T4 is 55 pmol/L. TSH receptor antibodies are positive. What is the most appropriate first-line medical treatment?

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Correct answer: D — Carbimazole

Graves disease (diffuse goitre, exophthalmos, positive TSH receptor antibodies) in a child should be treated with carbimazole as first-line antithyroid drug. Propranolol can be added for symptomatic relief of tremor and tachycardia. Propylthiouracil is avoided in children due to hepatotoxicity risk.

Reference: Australian Therapeutic Guidelines – 2024 – Endocrine; RACP Paediatric Curriculum – Endocrine