Podcast
Questions and Answers
Which of the following is the most common cause of endogenous hyperthyroidism?
Which of the following is the most common cause of endogenous hyperthyroidism?
- Thyroid cancer
- Hashimoto's thyroiditis
- Pituitary adenoma
- Graves' disease (correct)
Which triad of manifestations characterizes Graves' disease?
Which triad of manifestations characterizes Graves' disease?
- Muscle weakness, fatigue, and hair loss
- Thyrotoxicosis, exophthalmos, and pretibial myxedema (correct)
- Cold intolerance, dry skin, and bradycardia
- Goiter, weight gain, and constipation
What percentage of patients with Graves' disease typically exhibit exophthalmos?
What percentage of patients with Graves' disease typically exhibit exophthalmos?
- 90%
- 70%
- 10%
- 40% (correct)
Which of the following best describes pretibial myxedema?
Which of the following best describes pretibial myxedema?
In Graves' disease, the autoimmune reaction involves antibodies against which of the following?
In Graves' disease, the autoimmune reaction involves antibodies against which of the following?
The T cell mediated autoimmune reaction in Graves' disease is primarily involved in which of the following manifestations?
The T cell mediated autoimmune reaction in Graves' disease is primarily involved in which of the following manifestations?
Which laboratory findings are characteristic of Graves' disease?
Which laboratory findings are characteristic of Graves' disease?
In Graves' disease, radioactive iodine uptake is typically:
In Graves' disease, radioactive iodine uptake is typically:
What is the underlying pathogenic mechanism in Graves' disease that leads to hyperthyroidism?
What is the underlying pathogenic mechanism in Graves' disease that leads to hyperthyroidism?
Which of the following features distinguishes infiltrative ophthalmopathy of Graves' disease from other causes of proptosis?
Which of the following features distinguishes infiltrative ophthalmopathy of Graves' disease from other causes of proptosis?
Which of the following is a key feature in the pathogenesis of Graves' ophthalmopathy?
Which of the following is a key feature in the pathogenesis of Graves' ophthalmopathy?
Which statement accurately contrasts hyperthyroidism and hypothyroidism?
Which statement accurately contrasts hyperthyroidism and hypothyroidism?
What distinguishes the autoantibodies in Hashimoto's thyroiditis from those in Graves' disease?
What distinguishes the autoantibodies in Hashimoto's thyroiditis from those in Graves' disease?
Which dermopathy is specifically associated with Graves' disease?
Which dermopathy is specifically associated with Graves' disease?
What is the MAIN difference between T3 and T4 hormones?
What is the MAIN difference between T3 and T4 hormones?
What role do TSH receptors play in the pathogenesis of Graves' disease?
What role do TSH receptors play in the pathogenesis of Graves' disease?
A patient presents with unexplained weight loss, heat intolerance, and increased heart rate. Which INITIAL laboratory test would be most appropriate to evaluate for hyperthyroidism?
A patient presents with unexplained weight loss, heat intolerance, and increased heart rate. Which INITIAL laboratory test would be most appropriate to evaluate for hyperthyroidism?
A patient with Graves' disease is treated with radioactive iodine. What is the MOST likely long-term complication of this treatment?
A patient with Graves' disease is treated with radioactive iodine. What is the MOST likely long-term complication of this treatment?
A patient with Graves' disease develops pretibial myxedema. Which of the following is the MOST appropriate initial management strategy for this condition?
A patient with Graves' disease develops pretibial myxedema. Which of the following is the MOST appropriate initial management strategy for this condition?
A patient with Graves' disease and severe ophthalmopathy is being considered for treatment. Which of the following is the most appropriate treatment option to reduce the severity of the ophthalmopathy?
A patient with Graves' disease and severe ophthalmopathy is being considered for treatment. Which of the following is the most appropriate treatment option to reduce the severity of the ophthalmopathy?
Which of the following findings suggests a diagnosis of primary hyperparathyroidism rather than secondary hyperparathyroidism?
Which of the following findings suggests a diagnosis of primary hyperparathyroidism rather than secondary hyperparathyroidism?
What is the effect of parathyroid hormone (PTH) on serum phosphate levels?
What is the effect of parathyroid hormone (PTH) on serum phosphate levels?
Which of the following can cause hypoparathyroidism?
Which of the following can cause hypoparathyroidism?
Which clinical manifestation is associated with hypocalcemia?
Which clinical manifestation is associated with hypocalcemia?
You're treating a patient with suspected hypoparathyroidism, who is currently experiencing acute tetany. Which of the following is the MOST appropriate immediate treatment?
You're treating a patient with suspected hypoparathyroidism, who is currently experiencing acute tetany. Which of the following is the MOST appropriate immediate treatment?
A patient with chronic kidney disease develops secondary hyperparathyroidism. What is the PRIMARY mechanism driving this condition?
A patient with chronic kidney disease develops secondary hyperparathyroidism. What is the PRIMARY mechanism driving this condition?
What is the expected impact of elevated PTH levels on bone remodeling?
What is the expected impact of elevated PTH levels on bone remodeling?
Which of the following is a potential long-term complication of untreated primary hyperparathyroidism?
Which of the following is a potential long-term complication of untreated primary hyperparathyroidism?
Which of the following is the MOST common cause of primary hyperparathyroidism?
Which of the following is the MOST common cause of primary hyperparathyroidism?
What is the likely pathogenesis underlying the development of 'hungry bone syndrome' following parathyroidectomy for primary hyperparathyroidism?
What is the likely pathogenesis underlying the development of 'hungry bone syndrome' following parathyroidectomy for primary hyperparathyroidism?
What is the underlying cause of DiGeorge syndrome resulting in hypoparathyroidism?
What is the underlying cause of DiGeorge syndrome resulting in hypoparathyroidism?
A 50-year-old female presents with fatigue, bone pain, and constipation. Her lab results show elevated serum calcium and elevated PTH levels. Further investigation reveals elevated levels of gastrin. Which condition is MOST likely?
A 50-year-old female presents with fatigue, bone pain, and constipation. Her lab results show elevated serum calcium and elevated PTH levels. Further investigation reveals elevated levels of gastrin. Which condition is MOST likely?
During a thyroidectomy, all parathyroid glands are inadvertently removed. Post-operatively, the patient develops severe hypocalcemia. Which of the following is the MOST important IMMEDIATE step in managing this patient?
During a thyroidectomy, all parathyroid glands are inadvertently removed. Post-operatively, the patient develops severe hypocalcemia. Which of the following is the MOST important IMMEDIATE step in managing this patient?
Which medication class should be avoided in a patient with hyperparathyroidism due to an increased risk of hypercalcemic crisis?
Which medication class should be avoided in a patient with hyperparathyroidism due to an increased risk of hypercalcemic crisis?
What is the diagnostic challenge in familial hypocalciuric hypercalcemia (FHH) that distinguishes it from primary hyperparathyroidism?
What is the diagnostic challenge in familial hypocalciuric hypercalcemia (FHH) that distinguishes it from primary hyperparathyroidism?
A patient presents with signs and symptoms of hypercalcemia, including fatigue, muscle weakness, and constipation. Her diagnostic workup reveals an elevated serum calcium level along with a suppressed parathyroid hormone (PTH) level. What is the MOST likely etiology of her hypercalcemia?
A patient presents with signs and symptoms of hypercalcemia, including fatigue, muscle weakness, and constipation. Her diagnostic workup reveals an elevated serum calcium level along with a suppressed parathyroid hormone (PTH) level. What is the MOST likely etiology of her hypercalcemia?
A patient presents with carpopedal spasm during blood pressure measurement. Which of these would be the MOST appropriate next step to evaluate the underlying cause?
A patient presents with carpopedal spasm during blood pressure measurement. Which of these would be the MOST appropriate next step to evaluate the underlying cause?
A patient presents with a history of chronic kidney disease and is found to have the following laboratory values: serum calcium 7.8 mg/dL (normal: 8.5-10.5 mg/dL), serum phosphate 5.8 mg/dL (normal: 2.5-4.5 mg/dL), and intact PTH 550 pg/mL (normal: 10-65 pg/mL). What is the MOST likely diagnosis?
A patient presents with a history of chronic kidney disease and is found to have the following laboratory values: serum calcium 7.8 mg/dL (normal: 8.5-10.5 mg/dL), serum phosphate 5.8 mg/dL (normal: 2.5-4.5 mg/dL), and intact PTH 550 pg/mL (normal: 10-65 pg/mL). What is the MOST likely diagnosis?
A 30-year-old female presents with recurrent kidney stones. Further evaluation reveals hypercalcemia and elevated PTH. A Sestamibi scan reveals enlargement of two parathyroid glands. What is the MOST likely diagnosis?
A 30-year-old female presents with recurrent kidney stones. Further evaluation reveals hypercalcemia and elevated PTH. A Sestamibi scan reveals enlargement of two parathyroid glands. What is the MOST likely diagnosis?
Flashcards
Hyperthyroidism/Thyrotoxicosis
Hyperthyroidism/Thyrotoxicosis
Excessive thyroid hormone levels in the body, leading to accelerated metabolism.
Graves' Disease
Graves' Disease
An autoimmune disease and the most common cause of endogenous hyperthyroidism, characterized by a triad of manifestations.
Graves' disease: Triad
Graves' disease: Triad
A triad of manifestations including thyrotoxicosis, exophthalmos, and pretibial myxedema.
Thyrotoxicosis
Thyrotoxicosis
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Exophthalmos
Exophthalmos
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Pretibial Myxedema
Pretibial Myxedema
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Graves' Disease Pathogenesis
Graves' Disease Pathogenesis
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T cell role in Graves’
T cell role in Graves’
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Graves' Disease: Lab Features
Graves' Disease: Lab Features
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Radioactive iodine uptake in Graves’
Radioactive iodine uptake in Graves’
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Study Notes
- Diseases of the thyroid and parathyroid glands will be discussed.
Contents
- The conversation will include thyroid diseases such as hyper and hypothyroidism.
- The conversation will include parathyroid diseases such as hyper and hypoparathyroidism.
Objectives
- The causes, clinicopathologic features, pathophysiologic basis, and laboratory findings of both hyperthyroidism and hypothyroidism will be compared and contrasted.
- Several causes for hyperparathyroidism and hypoparathyroidism will be listed.
- The clinicopathologic features of hyperparathyroidism and hypoparathyroidism will be compared and contrasted.
Hyperthyroidism/Thyrotoxicosis: Graves Disease
- Graves disease is the most common cause of endogenous hyperthyroidism.
- It's characterized by a triad of manifestations:
- Thyrotoxicosis is caused by a diffusely enlarged, hyper functional thyroid.
- Infiltrative ophthalmopathy, with associated exophthalmos, is observed in as many as 40% of patients.
- A localized, infiltrative dermopathy also called pretibial myxedema, appears in a minority of cases.
Pathogenesis of Graves Disease
- Graves' disease is an autoimmune condition.
- Antibody-mediated autoimmune reaction occurs against thyroid-stimulating hormone receptors that bind to and stimulate thyroid follicular cells independently of endogenous trophic hormones.
- T cell-mediated autoimmune reaction is involved in infiltrative ophthalmopathy and dermopathy.
Lab Features of Graves Disease
- Elevations in serum free T3 and T4 and decreased serum thyroid-stimulating hormone are included in laboratory findings.
- Radioactive iodine uptake is increased diffusely due to continuous stimulation of thyroid follicles by thyroid-stimulating autoantibodies.
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