Which of the following is a sign of thyrotoxic crisis in Graves' disease?

• A. Fever
• B. Pallor
• C. Bradycardia
• D. Weight gain

Answer: (A)

Thyrotoxic crisis, or thyroid storm, is an extreme hyperthyroid state where the body’s metabolism ramps up dramatically and the system becomes unstable. Fever is a hallmark of this crisis because the extreme metabolic activity generates excess heat and the body’s temperature regulation is overwhelmed, often accompanied by an inflammatory response.

In this situation you also expect signs of sympathetic overdrive, like rapid heart rate and sweating, reflecting the powerful effects of excess thyroid hormone on the cardiovascular system. The other choices don’t fit this picture: pallor and weight gain are more associated with reduced metabolic activity or different disorders, and bradycardia contradicts the heightened adrenergic state seen in thyroid storm. Fever best aligns with the acute, hypermetabolic nature of a thyrotoxic crisis.