A 32-year-old male presents complaining of severe anxiety. F…
A 32-year-old male presents complaining of severe anxiety. For the last 4 months, he has had difficulty sleeping, progressively worsening anxiety, a 25-lb weight loss, and constantly feels “too warm.” He feels “shaky” and has difficulty concentrating. He denies diarrhea, but reports having normally shaped stools four to five times per day—more than usual for him. The patient denies neck or eye discomfort and has not noticed any neck swelling. He has no other significant medical history. His mother, who died 3 years ago from coronary artery disease (CAD), had a “thyroid problem,” but he doesn’t know any details. Physical examination reveals an anxious young adult male. He has a noticeable resting tremor. You note mild exophthalmos, conjunctival injection, and lid lag. His thyroid is diffusely, mildly enlarged, is non-tender, and a bruit is audible over the gland. The cardiac examination reveals tachycardia with a flow murmur. The rest of the examination is unremarkable. What is the most likely diagnosis?