A 25-Year-Old Woman, Gravida 1 Para 1, Is Evaluated for Fatigue

A 25-year-old woman, gravida 1 para 1, is evaluated for fatigue, palpitation, excessive sweating, and tremor that began 2 weeks ago.  Two months before the current visit, she delivered a male child at 39 weeks gestation by an uncomplicated vaginal delivery.  The patient has been breastfeeding her infant.  She reports no chronic medical conditions.  Blood pressure is 140/70 mm Hg and pulse is 110/min.  Examination of the thyroid gland shows mild, nontender, diffuse enlargement without an audible bruit.  Bilateral lid lag is noted without proptosis or eye redness.  A fine tremor of her outstretched hands is present.  Deep tendon reflexes are brisk and symmetrical.  Laboratory results are as follows: In addition to propranolol, which of the following is the best therapy for this patient at this time?

A) Add prednisone
B) Add propylthiouracil
C) No additional therapy
D) Radioactive iodine therapy
E) Thyroidectomy

Correct Answer:

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