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Graves disease — RACP Paediatrics MCQ

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ModerateEndocrinology and growthGraves diseaseRACP Paediatrics

A 12-year-old girl has weight loss despite increased appetite, tremor, heat intolerance and declining school performance. Pulse is 126/min and she has a diffuse goitre with a bruit. TSH is suppressed and free T4 is elevated. What is the most likely diagnosis?

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Correct answer: A — Graves disease

Diffuse goitre with bruit, hyperthyroid symptoms and biochemical thyrotoxicosis is most consistent with Graves disease. Anxiety can mimic tremor and palpitations but would not suppress TSH or produce a goitre bruit. Thyroid receptor antibodies help confirm autoimmune hyperthyroidism.

Reference: RACP Knowledge Guides; Therapeutic Guidelines (eTG)