A 23-year-old woman presents with palpitations. Over the past 6 months, she has reported loose stools, a 10-lb (4.5-kg) weight loss despite a good appetite and food intake, and increased irritability. She appears to be anxious and has a pulse of 119 beats per minute and a blood pressure of 137/80 mm Hg. Her thyroid gland is diffusely and symmetrically enlarged to twice the normal size, and it is firm and nontender; a thyroid bruit is audible. She has an eyelid lag, but no proptosis or periorbital edema. The serum thyrotropin level is 0.02 µU per milliliter (normal range, 0.35 to 4.50) and the level of free thyroxine is 4.10 ng per deciliter (normal range, 0.89 to 1.76).
How should she be further evaluated and treated?
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