Graves' disease — SCE Endocrinology MCQ

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ModerateThyroidGraves' diseaseSCE Endocrinology

A 32-year-old woman presents with weight loss, tremor and palpitations. She has a small diffuse goitre, lid lag and TSH <0.01 mU/L with free T4 42 pmol/L. TSH receptor antibody is positive. What is the most likely diagnosis?

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Correct answer: E — Graves' disease

Suppressed TSH, raised free T4, diffuse goitre and positive TSH receptor antibody make Graves' disease most likely. Toxic multinodular goitre is more typical in older patients with nodularity, and thyroiditis usually has low uptake and neck pain or viral prodrome. TSH-secreting adenoma would usually have non-suppressed TSH.

Reference: NICE NG145; BNF