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Graves disease — MCCQE Part 1 MCQ

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ModerateThyroid DisordersGraves diseaseMCCQE Part 1

A 32-year-old woman presents with weight loss, tremor and heat intolerance. Pulse is 116/min and examination shows a diffuse goitre with a bruit and mild lid lag. TSH is suppressed and free T4 is elevated. What is the most likely diagnosis?

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Correct answer: A — Graves disease

Hyperthyroidism with a diffuse vascular goitre and eye signs is most consistent with Graves disease. Subacute thyroiditis usually causes a painful thyroid and transient thyrotoxicosis. Anxiety can mimic symptoms but does not explain suppressed TSH, raised free T4 and a goitre with bruit.

Reference: Choosing Wisely Canada Endocrinology; MCC Objectives—Thyroid Disorders