DrVirgo
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Topics: 1096
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A 24-year-old man comes to the clinic complaining of a
painful neck. For the past week, he has had an exquisitely
tender lump in his neck. Additionally, he has suffered
from heart palpitations and insomnia, and he reports
feeling “grouchy.” Although his past medical history is
unremarkable, a review of systems reveals a recent history
of cough, fever, and myalgias, now resolved.Vital signs
are: temperature 38.0 C (100.4 F), blood pressure 138/88
mm Hg, pulse 121/min, and respirations 20/min.
Examination reveals a palpable, non-nodular, and
extremely tender thyroid gland. A mild tremor is present
when the patient extends his arms. Thyroid function tests
show:
Thyroid-stimulating 0.01 μU/mL
hormone (TSH)
Thyroxine (T4) 12.8 μg/dL
A 24-hour radiouptake study performed on this patient
most likely would reveal which of the following?
(A) Diminished radioactive iodine uptake throughout
the entire thyroid gland
(B) Focal area of increased uptake; rest of the gland
displaying reduced uptake
(C) Increased uptake of radioactive iodine throughout
the entire thyroid gland
(D) Nodular areas of increased uptake surrounded by
areas of reduced uptake
(E) Normal radioactive iodine uptake scan; no abnormalities
noted
-Also: What is the diagnosis?
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| sarika
Forum Guru
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its graves disease. D) Nodular areas of increased uptake surrounded by
areas of reduced uptake
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| CocaCola
Forum Guru
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A - diminished uptake throughtout the entire gland
It's throiditis
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| doc_clotaire
Forum Guru
Topics: 159
Posts: 1,247
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This is Typical for Subacute Thyroiditis ( painfull thyroid , fever and myalgia , signs of Hypethyroidism .... adrenergic effects )
The answer is
A ) because the realease of preformed TH from the gland supresses TSH levels which is responsible for the radioactive iodine uptake thoughout the gland
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| sarika
Forum Guru
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sorry u guys r right i dint even read painful... or maybe drvirgi added it after i read the question.,......hmmmmmm
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| DrVirgo
Forum Hero
Topics: 1096
Posts: 3,515
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The correct answer is A. Although a radioactive uptake
scan is not necessary to diagnosis this patient’s condition,
subacute thyroiditis, it is a common way to think
of the pathogenesis of hyperthyroidism. Conditions
that increase thyroid activity, such as Graves disease,
can be expected to result in increased incorporation of
iodine and will result in increased uptake of the
radioactive tracer. Conditions that result in increased
thyroid hormone without increasing the production of
hormone, basically exogenous hormone (sometimes
taken for weight loss), or inflammatory damage of the
thyroid and release of colloid, result in reduced uptake.
The excess thyroid hormone results in feedback inhibition
of TSH, resulting in less uptake of iodine. Subacute
thyroiditis, in which thyroxine is “spilled” from an
inflamed thyroid gland, can result in frank hyperthyroidism
with a reduced uptake of radioactive iodine.
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