A 28-year-old woman is complains of nervousness, a 3-kilograms weight loss, hotness and palpation. On exam thyroid gland is enlarged and she has prominent eyes and when asked to follow your finger, moving downward from above, the sclera can temporarily be seen above the iris. What is the most likely diagnosis?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Graves' disease
Thyrotoxic symptoms + goitre + prominent eyes + lid lag on downward gaze (von Graefe sign) = Graves disease; eye signs such as exophthalmos are specific to Graves. Subacute thyroiditis has a tender gland after a viral illness and no eye disease; thyroid storm needs fever, delirium and severe tachycardia; Hashimoto is usually hypothyroid.
ليش كل خيار صح أو غلط
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A
ليش غلط
Thyroid storm is a rare, life-threatening crisis with hyperpyrexia, tachycardia and hypotension/shock; this patient has ordinary thyrotoxic symptoms and no fever or shock.
✓ Endocrine ✳️.pdf · p. 13 -
B
ليش غلط
Cancer is suggested by a solitary, fixed, unusually firm nodule (or a history of neck radiation), not by an enlarged thyrotoxic gland with eye signs.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 11 -
C
ليش غلط
Subacute thyroiditis follows a viral illness (fever, flu-like prodrome) and gives a painful, tender gland; no such prodrome or tenderness is described here, and she has eye signs.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 9 -
D
ليش صح
Exophthalmos is one of the three signs of hyperthyroidism specific to Graves disease (with pretibial myxedema and thyroid bruit); with weight loss, heat intolerance and palpitations it points to Graves.
✓ Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 3 -
E
ليش غلط
Hashimoto is autoimmune destruction of the follicular cells causing hypothyroidism; the patient here is hyperthyroid.
✓ Thyroid disorders.pdf · p. 3
- المصدر
- view-material.pdf · p. 118
Step Up To Medicine 6th Edition 2024 (Thyroid).pdf · p. 3 - المحاضرة
- Thyroid Disorders · Endocrinology · Module B
- ظهر في
- Endo bank