A 34-year-old woman comes to the physician because of a 3-month history of fatigue and a 4.5-kg (10-lb) weight loss despite eating more than usual. Her pulse is 115/min and blood pressure is 140/60 mm Hg. Physical examination shows warm, moist skin, and a diffuse, non-tender swelling over the anterior neck. Ophthalmologic examination shows swelling of the eyelids and proptosis bilaterally. Which of the following is the most likely cause of this patient's symptoms?
AConstitutively active TSH receptor
BThyrotropin receptor autoantibodies
CParafollicular cell hyperplasia
DThyroid peroxidase autoantibodies
ENongranulomatous thyroid inflammation
A 32-year-old woman presents with a 3-month history of intermittent blurred vision and problems walking. The patient states that she often feels “pins and needles” in her legs that cause her problems when she’s walking. The patient is afebrile, and her vital signs are within normal limits. An autoimmune disorder is suspected. Which of the following findings would most likely be present in this patient?
ADamaged myelin sheath and myelin-producing cells
BAbsence of interneurons
CDestruction of blood-brain barrier
DDegeneration of anterior horn cells
EDecreased cerebrospinal fluid due to destruction of cells
A 43-year-old woman presents to the physician with the complaint of worsening fatigue over the past several months. She has found that she requires nearly double the amount of coffee consumption each day to stay awake at work and that despite maintaining a balanced, healthy diet, she has experienced significant weight gain. A blood test confirms the presence of anti-thyroid peroxidase antibodies. Which of the following additional findings would be most consistent with the underlying pathophysiology of her condition?
AGalactorrhea
BConstipation
CBrisk deep tendon reflexes
DDiarrhea
EHeat intolerance
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