BOF: 2.70
A 53-year-old female who was on amiodarone presents with weight loss
despite a good appetite, heat intolerance, tremors and excessive sweating.
On examination she has exophthalmos and a palpable goitre. Pulse rate
was 120 beats per minute regular and she had a fine tremor of her hands
Thyroid function tests showed the following values: thyroid stimulating
hormone (TSH), < 0.03 mIU/L (normal, 0.5-5.0 mIU/L); thyroxine (T4),
15.3 µg/dL (normal, 4.0-10.5 µg/dL); triiodothyronine (T3), 256
ng/dL (normal, 80-200 ng/dL); free thyroxine index (FT4I), 19.4
(normal, 4.7-10.0). She was positive for thyroid peroxidase (“microsomal”) antibodies, and
thyroid stimulating immunoglobulin.
In this patient the most
suitable initial treatment would be a combination of:
a) Steroids and azathioprine
b) Carbimazole and radioactive
iodine
c) Potassium perchlorate and
carbimazole
d) Carbimazole and surgery
e) Steroids and carbimazole
