Toxic multinodular goiter Quiz: Ace Your Exams

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A 38-year-old woman came to the office due to anxiety and palpitations for the past 2 months. She also notes a 6 lbs (2.7 kg) weight loss over this time period without changes in her diet. The patient is generally healthy; medical history is unremarkable. She does not consume caffeine, alcohol or illicit drugs. Temperature is 37.0°C (98.6°F), pulse is 115/min, and blood pressure is 125/85 mmHg. On physical examination, the patient’s skin is moist, and a fine hand tremor is noted. The thyroid gland is diffusely enlarged and nontender. Laboratory tests are obtained and shown below:


Which of the following is the most likely diagnosis?

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