Hyperthyroidism (Graves Disease)

Endocrine · ~6% of blueprint

Pathophysiology: TSH-receptor–stimulating antibodies drive excess thyroid hormone production.
Signs & Symptoms: Weight loss, heat intolerance, palpitations, tremor, anxiety; exophthalmos & pretibial myxedema (Graves).
Gold Standard Diagnosis: ↓ TSH with ↑ free T4/T3; diffuse ↑ radioactive iodine uptake; TSI antibodies.
First-line Treatment: Methimazole (first-line) ± beta-blocker; radioiodine ablation or surgery; PTU in the 1st trimester.

High-Yield Pearl

Methimazole is first-line except in the 1st trimester (use PTU) — methimazole is teratogenic early.

Sources

Reviewed September 2026

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