PANCE Exam Practice Questions: Quiz 860

A 28-year-old female complains of fatigue and a sense of fullness at the base of her neck. She has no significant past medical history, gave birth to a healthy infant 4 months ago, and is only taking oral contraceptives. On examination, vital signs are pulse 88, blood pressure 110/66, temperature 98.6°F, and respirations 12. Her thyroid gland is homogeneously enlarged and she has a very mild tremor of the outstretched hands. The rest of the examination is within normal limits. Laboratory evaluation reveals the following: WBC: 7800/µL Hgb: 12.3 g/dL Hct: 36% Plt: 220,000/µL Na: 138 mEq/L K: 4.0 mEq/L Cl: 106 mEq/L CO2: 26 mEq/L BUN: 12 mg/dL Creatinine: 0.7 mg/dL TSH: 0.01 mIU/L (normal 0.4-4) T4: 19 nmol/L (normal 5-12) Antithyroid antibody test (TPO antibodies): elevated What is the most likely diagnosis?
- a. Thyrotoxicosis factitia
- b. Subacute thyroiditis
- c. Toxic multinodular goiter
- d. Postpartum thyroiditis

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