A 45-year-old woman presented to our clinic in July 2019 for evaluation of intermittent fever, rigors, diaphoresis, malaise, and urinary symptoms of frequency and urgency of 5 days’ duration. Her history was notable for Graves disease after total thyroidectomy 8 months previously after failed medical management, with no neck swelling or pain at present; an incidentally discovered and resected papillary thyroid microcarcinoma; and hypertension. A reconciled medication list included levothyroxine (125 μg/d), sertraline (100 mg/d), amphetamine-dextroamphetamine (20 mg/d), propranolol (40 mg twice daily), selenium (200 μg/d), and biotin (10 mg/d). She reported no relevant family history or sick contacts, but she may have had tick exposure. Physical examination revealed a temperature of 39.4 °C, heart rate of 64 beats/min, blood pressure of 98/56 mm Hg, weight of 85 kg, exophthalmos and lagophthalmos, and healed Kocher incision with no neck masses or tenderness. Abdominal examination revealed mild suprapubic tenderness.

CORRECT ANSWERS: 1. b. 2. d. 3. b. 4. a. 5. e