A 65-year-old female patient with no notable medical history
presents with progressive symptoms over several months including insomnia, nervousness, fatigue, increased appetite despite weight loss, occasional palpitations, and heat intolerance.
Her family history includes thyroid disease in her maternal grandmother.
Physical examination reveals tachycardia, lid lag, a mildly enlarged but soft and non-tender thyroid with palpable isthmus, hyperreflexia, and fine hand tremors.
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