drashishmahajan
Forum Senior
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A 24-year-old Caucasian male comes to the outpatient clinic with complaints of heat intolerance and increased appetite. On examination, PR: 110/min and regular; Temperature: 37.2C(99F); RR: 14/min. Swelling is noted in the front of his neck, which moves with deglutition. Lab studies show: increased total T4; increased free T4; and decreased TSH. Radioactive iodine uptake is decreased. What is the most likely diagnosis?
A. Multinodular goiter
B. Toxic adenoma
C. Graves disease
D. Struma ovarii
E. Thyroiditis
Please explain too...
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| prathapdoctor
Forum Elite
Topics: 12
Posts: 406
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its a case of thyroiditis,in thyroiditis - because of inflammation and destruction of follicles,the already synthesised and stored hormones will be suddenly released in to the circulation because of which there will be elevation in T3 AND T4 levels,which leads to inhibition of TSH production by pitutary.thyroid scan will show decreased up take because T3 and T4 syn is low but the manifestations are because of sudden release of already synthesised and stored horomones in to ciculation.
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| chemamr
Forum Hero
Topics: 703
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it looks like a thyroiditis. E.
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| CocaCola
Forum Guru
Topics: 35
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E - thyroiditis
only one thats presents high hormone levels without increased uptake
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| nida
Forum Elite
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agree, E - thyroiditis
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| drashishmahajan
Forum Senior
Topics: 6
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i agree wid u all .. can u explain how is it tht the radioactive uptake is more in toxic nodular goiter or multinodular goiter..
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| CocaCola
Forum Guru
Topics: 35
Posts: 907
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there is an increased uptake of iodine in toxic adenoma, multinodular goiter and graves to produce more hormone... the gland is overactive...
In thyroiditis the gland is damaged leading to spilling of hormone out the gland, but the gland itself isn't actively producing hormone so iodine uptake is less...
___________________
There is one thing we can do, and the happiest people are those who can do it to the limit of their ability. We can be completely present. We can be all here. We can give all our attention to the opportunity before us!!!
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