A 28-year-old woman returns for follow-up after routine laboratory tests show a markedly elevated…

A 28-year-old woman returns for follow-up after routine
laboratory tests show a markedly elevated total T4 level. The patient is
totally asymptomatic, and the physical examination is unremarkable.

Questions

A. What conditions and medications could be responsible for
this presentation?

B. What further laboratory tests should be ordered?

C. If the patient is pregnant, how can the elevated total
plasma T4 level be explained?

D. If several asymptomatic family members have been told of
similar laboratory test results, what is the most likely explanation of the
patient’s disorder?

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