Toxic multinodular goiter Quiz: Ace Your Exams

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A 40-year-old woman comes to the clinic due to anxiety and eye pain for the past few months. The patient also discloses a 10 lb (4.5 kg) weight loss over the past 2 months without changes in her diet. Medical history is unremarkable, and she does not use caffeine, alcohol, or illicit drugs. Temperature is 37.0°C (98.6°F), pulse is 110/min, and blood pressure is 135/85 mmHg. On physical examination, the patient's skin is moist, and a diffuse goiter is noted. Examination of the eyes reveals mild exophthalmos and conjunctival erythema. Which of the following is most likely involved in the pathogenesis of this patient’s eye condition?

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