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Patient case: Hyperthyroidism

Discussion

A 38-year-old female presents to the clinic with complaints of unexplained weight loss, increased sweating, and palpitations over the past three months. She reports feeling anxious and irritable and experiencing tremors in her hands. Her menstrual cycles have also become irregular. On physical examination, her thyroid gland appears enlarged, with no palpable nodules. Her heart rate is elevated at 110 beats per minute, and she has a fine tremor in her hands.

Laboratory tests reveal elevated free T4 and suppressed TSH levels, confirming the diagnosis of hyperthyroidism. A thyroid scan later shows increased uptake consistent with Graves' disease.

The patient is started on antithyroid medications and advised to follow up regularly for monitoring her thyroid function and medication adjustment.

Questions
1. Which of the following symptoms is NOT commonly associated with hyperthyroidism?

a) Weight gain

b) Palpitations

c) Hand tremors

d) Increased sweating

2. Which physical finding is commonly observed in patients with hyperthyroidism?

a) Enlarged lymph nodes

b) Enlarged thyroid gland

c) Pale skin

d) Swollen ankles

3. What is the most likely cause of hyperthyroidism in this patient?

a) Hashimoto's thyroiditis

b) Graves' disease

c) Thyroid cancer

d) Iodine deficiency

4. Which of the following is a first-line treatment for hyperthyroidism?

a) Radioactive iodine therapy

b) Antithyroid medications

c) Thyroidectomy

d) Beta-blockers alone

Reveal answers

Answers

1. a) Weight gain

2. b) Enlarged thyroid gland

3. b) Graves' disease

4. b) Antithyroid medications

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