Question

a 47 - year - old woman reports that she is feeling shaky, sweaty, and anxious. she has recently begun to lose weight without any change in her diet or lifestyle. lab work reveals increased t3/t4, decreased trh, and decreased tsh. what autoantibodies are you most likely to find with this patient that would help with your diagnosis?
a) thryoglobulin
b) thyroid stimulating immunoglobulin
c) tertiary hypothyroidism
d) thyroid peroxidase
e) thyroid stimulating hormone

Explanation:

The patient has symptoms of hyperthyroidism (shaky, sweaty, anxious, weight loss) and lab results (increased T3/T4, decreased TRH, decreased TSH) consistent with Graves' disease. In Graves' disease, thyroid - stimulating immunoglobulin (TSI) is present. TSI mimics the action of thyroid - stimulating hormone (TSH) and stimulates the thyroid gland to produce excessive thyroid hormones (T3/T4). This over - production of T3/T4 leads to negative feedback on the hypothalamus (decreased TRH) and the anterior pituitary (decreased TSH).
Thyroglobulin antibodies (a) and thyroid peroxidase antibodies (d) are more commonly associated with Hashimoto's thyroiditis (hypothyroidism). Tertiary hypothyroidism (c) is a disorder of the hypothalamus and would present with different hormonal patterns (low TRH, low TSH, low T3/T4). Thyroid - stimulating hormone (e) is a hormone produced by the anterior pituitary, not an autoantibody.

Answer:

B. thyroid stimulating immunoglobulin