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Graves disease — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Graves diseaseUSMLE Step 3

A 35-year-old woman has palpitations, tremor, heat intolerance, and weight loss. Examination shows diffuse goiter and mild proptosis. TSH is suppressed and free thyroxine is elevated. Thyroid-stimulating immunoglobulin is positive. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: C — IgG stimulation of the TSH receptor

Graves disease is caused by thyroid-stimulating immunoglobulins that activate the TSH receptor, producing diffuse hyperthyroidism.

Reference: American Thyroid Association Hyperthyroidism Guideline