A 45-year-old woman presents with progressive fatigue, weight gain of 8 kg over 3 months, constipation, and cold intolerance. Vital signs show BP 128/82 mmHg, HR 58 bpm, RR 14/min, temperature 36.2°C. Examination reveals a painless, firm, diffusely enlarged thyroid gland without nodules. Laboratory studies demonstrate TSH 12.5 mIU/L (elevated), free T4 0.6 ng/dL (low), and positive anti-thyroid peroxidase antibodies. Thyroid ultrasound shows homogeneous echotexture. She denies recent iodine exposure. Which of the following is the most likely diagnosis?

  1. A)Medullary thyroid carcinoma
  2. B)Toxic multinodular goiter
  3. C)Hashimoto thyroiditisGABARITO
  4. D)Subacute granulomatous thyroiditis
  5. E)Graves disease

Explicação

Hashimoto thyroiditis is an autoimmune destruction of the thyroid characterized by anti thyroid peroxidase and anti thyroglobulin antibodies. Patients usually present with hypothyroidism and a painless goiter. Histologically there is lymphoid aggregation with ... Ver explicação completa e trilha adaptativa →

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