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Hyperthyroidism — MCCQE Part 1 MCQ

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EasyWeight LossHyperthyroidismMCCQE Part 1

38-year-old man presents with weight loss despite increased appetite. He has tremor, heat intolerance and sinus tachycardia. Which of the following is the most appropriate next step?

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Correct answer: E — Check TSH/free T4 and start symptomatic beta-blockade if needed

Check TSH/free T4 and start symptomatic beta-blockade if needed is best because the syndrome is thyrotoxicosis and thyroid function confirms it. Discharge with reassurance and routine follow-up only is suboptimal because it underestimates acute or progressive risk; Treat symptomatically and defer definitive assessment is suboptimal because symptom control alone does not address the likely underlying diagnosis; Arrange non-urgent outpatient imaging in several months is suboptimal because delayed imaging is unsafe when the presentation has red flags; Start long-term corticosteroids without confirming the diagnosis is suboptimal because empiric steroids can obscure infection, malignancy or other diagnoses. Thyroid disease commonly presents as constitutional or cardiovascular symptoms.

Reference: Canadian endocrine guidance