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Retired NBME 19 Answers

nbme19/Block 1/Question#35 (reveal difficulty score)
A 25-year-old woman has recently developed ...
Thyrotropin receptor autoantibodies ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: graves

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submitted by โˆ—chaosawaits(92)
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I don't know about you, but I got hung up on the fact that she's in her 20s and female and "recently developed" her symptoms of hyperthyroidism. Hypothyroid disorders are more common than hyperthyroid disorders and Hashimoto's disease, which is the most common hypothyroid disorder, has an initial hyperthyroidism. So I went with C "thyroid peroxidase autoantibodies." To be honest, the only thing that makes me confident it's not early Hashimoto's still is that B is also an autoantibody of Hashimoto's. And there can't be two right answers. So that leaves D "Thyrotropin receptor autoantibodies" (Grave's disease) as the correct answer. Better responses requested:

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chaosawaits  So I think the only defining information that really points to Grave's and only Grave's is that her symptoms started around the time she developed nervousness and emotional lability. Since Grave's often presents in stress (FA2019, p339), it has to be Grave's. Personally, I think this is an awful question still. +
chaosawaits  Furthermore, "wide-eyed" is apparently code for "proptosis" which is another word for "exophthalmos" which is unique for Grave's disease +1



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