🏥 USMLE Exam Prep

A 48-year-old woman presents with palpitations, heat intolerance, weight loss despite increased appetite, and tremor. Her thyroid-stimulating hormone (TSH) is <0.01 mIU/L, and free T4 is elevated. Physical examination reveals an enlarged, non-tender thyroid gland with a bruit. Which of the following is the most appropriate initial pharmacological treatment?

A Levothyroxine
B Methimazole
C Iodine-131 therapy
D Propylthiouracil (PTU)

✓ Correct Answer: Option B

This patient has Graves' disease (hyperthyroidism). Methimazole is the preferred initial antithyroid medication due to its efficacy and once-daily dosing. PTU is generally reserved for the first trimester of pregnancy or thyroid storm.

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