NBME 12 question..Please help me with this - integrin

[ArchivalUser]

A 30 yr old woman comes to the physician because of a 7 week hx of palpitations and shortness of breath with exertion. Her pulse is 116 and respirations are 25/min Physical exam shows a non palpable thyroid gland there is no exopthalmos serum studies show

TSH 0.01
free T4 2.6
Iodine uptake 1% at 24 hours (normal is 8-30%)
thyroglobulin

[ArchivalUser]

hyroglobulin

[ArchivalUser]

hyroglobulin

[ArchivalUser]

Thyroglobulin < 0.5,(N is 2-55)thyroglobulin antibodies

[ArchivalUser]

Which of the following is the most likely underlying mechanism of these findings?(A) Exogenous use of levothyroxine(B) Lymphocytic infiltration of thyroid gland© Mutation activation in the TSH receptor(D) Stimulation of cytokines of B lymphocytes against thyroid antigens(E) Tumour production of Beta HCG

[ArchivalUser]

Sorry for fragmented question, I don't know what is wrong with posting line by line.Pls help