QuestionSBA
QuestionChoice
This answer is incorrect. Iodine deficiency is a cause of goitre but more commonly causes hypothyroidism. This patient has presented with symptoms of hyperthyroidism which is confirmed with thyroid function tests.
10007388
c
Iodine deficiency
QuestionChoice
This answer is incorrect. De Quervains thyroiditis is a cause of subacute hyperthyroidism which is associated with low TSH levels but normal levels of T4.
10007387
b
De Quervain's thyroiditis
QuestionChoice
This answer is incorrect. Hashimoto's thyroiditis is a cause of hypothyroidism. This patient has presented with symptoms of hyperthyroidism which is confirmed with thyroid function tests.
10007390
e
Hashimoto's thyroiditis
QuestionChoice
This answer is correct. The vignette describes classical symptoms of hyperthyroidism. The presence of a goitre and protruding eyes (proptosis) points towards a diagnosis of Grave's disease. In Grave's disease, up to 95% have anti-TSH receptor antibodies and up to 75% have anti-TPO antibodies.
10007386
a
Grave's disease
QuestionChoice
This answer is incorrect. A TSH secreting pituitary adenoma is a cause of secondary hyperthyroidism, where there are high TSH levels as well as high T4 levels.
10007389
d
TSH secreting pituitary adenoma
Concept
Chapter
2693
3959
Hyperthyroidism
Topic
133
Endocrinology
14024
A 25-year-old woman presents to the GP with weight loss, irritability, and a tremor.

On examination, she is found to have a goitre and protruding eyes.

Bloods:

* T4 - 14.3 micrograms/dL (5.0-12.0)
* TSH - 0.2 ml/IU (0.5-5.0)
* Anti-TSH receptor antibodies - postive
* Anti-TPO antibodies - positive

Which of the following is the most likely diagnosis?
a