[Expert Solution]: A 40-year-old female is brought into the…

A 40-year-old female is brought into the emergency department by her husband following a ‘severe panic attack’. She appears visibly distressed, reporting feeling ‘stressed’, with poor sleep and several episodes of diarrhea over the past 3 days. She was diagnosed with Graves’ disease 4 months previously but has not been compliant with medication due to concerns over side effects. On examination, she is orientated but anxious. Her heart rate is 135 beats per min, with a blood pressure of 100/55 mm Hg. She has pyrexia of 38.6°C. Initial laboratory investigations reveal a TSH <0.02 (normal range 0.2–5) mU litre−1 with free T4 40 (normal range 9–24) pmol/ litre. Which of the following statements are true? Select all that apply a. Propylthiouracil would be an appropriate first-line therapy in this patient. b. Plasma exchange is associated with poorer outcomes in patients with Graves’ disease c. A urine pregnancy test should be performed in this patient d. It is possible to distinguish thyrotoxicosis from thyroid storm based on the degree of derangement in TSH and thyroid hormone levels. e. β-Blockers are no problem to use in thyroid storm when there is clinical evidence of heart failure.