8th April 2024

A 50-year-old IT manager presents with bilateral hand tremor and hyperhidrosis

A 50-year-old IT manager presents with bilateral hand tremor and hyperhidrosis. He is concerned about Grave’s disease as his colleague has recently been diagnosed with this and had similar symptoms. His medical history is significant for vitiligo, for which he is seen by a Dermatologist, and hypertension, which is controlled on ramipril 2.5mg OD. He smokes 1-2 cigarettes a day for two weeks. He started smoking recently due to workplace stress at a new IT firm. He eats a lot of dairy and seafood and does not drink any alcohol. His observations are: HR 94 bpm, BP 145/89 mmHg, temperature 36.4C, RR 20 and saturations are 97% on room air.

Which of the following is the most likely risk factor for development of Grave’s disease in this case?

Select the SINGLE most appropriate option from the list below. Select ONE option only.