26th August 2020

An 18-year-old woman presents worried about lumps in her neck

An 18-year-old woman presents worried about lumps in her neck. On examination she has a bilateral multinodular goitre. On examination the patient is noticeably thin and tall. On closer inspection, her fingers and arm span are disproportionately long and she is noticeably sweating, but there is no sign of any tremor. On inspection of her mouth she has multiple lumps over her lips and tongue. Her blood pressure reading is 163/101 mmHg.

What investigation would confirm the likely underlying diagnosis?

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