Presentation

You are a final year medical student on a Medicine attachment. Dr. Raj, a consultant in Endocrinology, is the supervising doctor. 

Sam, a 32-year-old woman presents to the clinic that afternoon because of anxiety, palpitations, and easy fatigability. She also reports that she has difficulty sleeping at night and that her husband complains that she is keeping the house very cool. She is 8 weeks pregnant therefore she initially attributed these symptoms to her pregnancy. 

She goes on to tell you that she recently consulted her ophthalmologist because of redness and watering of the eyes. Eye drops were not helpful. Furthermore, in the last 2 months she has lost about 11 kg. Sam's gynecologist thought it was best that she sees an endocrinologist. 

On physical examination, her pulse rate is 100 bpm and her thyroid is slightly enlarged. Conjunctivae are red and she has a stare. 

Following further investigations, a diagnosis of Grave's disease is reached. 

STOP AND DISCUSS 

Which drug would you prescribe for Sam? 


  • Propranolol
  • Methimazole
  • Propylthiouracil
  • Guanethidine
  • Iodine (isotope 131)

Map: Sam Davis (1112)
Node: 21001
Score:

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