Posted by AAA from IP 207.200.116.72 on November 30, 2006 at 01:01:01:
A 57-year-old male presents with heat intolerance, increased appetite, diarrhea, and weight loss. He is a non-smoker and non-alcoholic. He has a history of hepatitis C, and is currently on ribavirin and interferon-alfa. His blood pressure is 130/80 mmHg, pulse rate is 90/min, and respiratory rate is 16/min. He is afebrile. On examination, there is a non-tender swelling on the front of his neck that moves with swallowing. On eye examination, there is no exophthalmos, ophthalmoplegia, lid lag, or chemosis. Examination of the lungs and heart is normal. Labs reveal elevated total T3 and T4 levels, low TSH level, decreased radioiodine uptake, and increased serum thyroglobulin levels. Which of the following is the most appropriate next step in the management of this patient?
A) Treatment with a beta-blocker
B) Treatment with propylthiouracil
C) Treatment with NSAIDs
D) Treatment with prednisolone
E) Treatment with radioiodine