Thyroid Disorders USMLE Step 1 Practice Question
A 19-year-old woman with recent viral infection presents with fatigue, weight loss despite increased appetite, palpitations, and anxiety. Examination reveals tremor, warm skin, and a diffuse, tender thyroid. TSH is <0.01 mIU/L, free T4 is 3.2 ng/dL, and thyroid peroxidase antibodies are positive. Which of the following is the most appropriate next step?
Answer choices
- APerform thyroid ultrasound and TSH receptor antibody testing
- BStart beta-blockers and NSAIDs; reassess in 4-6 weeks as symptoms typically resolveCorrect answer
- CStart levothyroxine for hypothyroid phase prevention
- DInitiate antithyroid drugs (PTU or methimazole) immediately
- EProceed to radioactive iodine ablation therapy
- FStart corticosteroids and schedule thyroidectomy within 2 weeks
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