Thyroiditis

A 32-year-old woman presents with acute onset severe thyroid pain, fever, and dysphagia 2 weeks after an upper respiratory tract infection. Thyroid function tests show suppressed TSH and elevated free T4. All of the following are consistent with acute (suppurative) thyroiditis EXCEPT:

Which of the following histological features is pathognomonic for Hashimoto's thyroiditis?

A 28-year-old woman with a history of Hashimoto's thyroiditis presents with acute severe thyroid pain, fever, and a tender thyroid nodule. Thyroid function tests show TSH 0.2 mIU/L and free T4 8.5 ng/dL (normal 0.8–1.8). Thyroid ultrasound shows a hypoechoic nodule with increased vascularity. What is the drug of choice for managing the acute inflammatory phase?

A 32-year-old woman presents with acute onset severe thyroid pain, fever, and dysphagia. On examination, the thyroid is tender and enlarged. TSH is suppressed (0.1 mIU/L) with elevated free T4 (18 pg/dL). Thyroid peroxidase (TPO) antibodies are negative. Which investigation is most specific for confirming the diagnosis of acute suppurative thyroiditis?

A 38-year-old woman presents with acute onset severe thyroid pain, fever, and dysphagia for 3 days. On examination, the thyroid is tender and enlarged. TSH is 0.2 mIU/L (low), free T4 is elevated at 28 pmol/L, and ESR is 95 mm/hr. Thyroid peroxidase (TPO) antibodies are negative. What is the most appropriate next step in management?