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?
- A)Perform thyroid ultrasound and TSH receptor antibody testing
- B)Start beta-blockers and NSAIDs; reassess in 4-6 weeks as symptoms typically resolveGABARITO
- C)Start levothyroxine for hypothyroid phase prevention
- D)Initiate antithyroid drugs (PTU or methimazole) immediately
- E)Proceed to radioactive iodine ablation therapy
Explicação
This is postpartum thyroiditis (or viral-triggered subacute thyroiditis) in the thyrotoxic phase. The thyroid is inflamed, not autonomously hyperactive. Management is supportive (beta-blockers for symptoms, NSAIDs for inflammation) while awaiting spontaneous r... Ver explicação completa e trilha adaptativa →