Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Interactive:
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Quiz
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Exams
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map

Review of Clinical Signs Review Questions

Signs and Symptoms of Thyroid Disease

Author: Bernard M. Karnath, MD

Choose the single best answer for each question.

1. A 35-year-old woman presents with a 2-month history of nervousness, palpitations, heat intolerance, frequent stools, and a 15-lb weight loss. Laboratory examination reveals a serum thyroid-stimulating hormone (TSH) level below 0.01 µU/mL (normal, 0.5-5.0 µU/mL] and a free thyroxine (FT4) level of 2.9 ng/dL (normal, 0.8-1.8 ng/dL). A radio-
active iodine uptake (RAIU) scan shows diffuse uptake. What is the most likely diagnosis?

  1. Graves’ disease
  2. Toxic nodular goiter
  3. Hashimoto’s thyroiditis
  4. de Quervain’s thyroiditis
  5. Factitious thyrotoxicosis
Click here to compare your answer.


2. A 39-year-old man presents with a 4-week history of weight loss, palpitations, and soreness in his neck. He reports that he had an upper respiratory tract infection about 1 month ago. Family history for thyroid disease is negative. On physical examination, his neck is extremely tender in the region of the thyroid gland. Laboratory examination reveals a serum TSH level below 0.01 µU/mL and a serum FT4 level of 3.1 ng/dL. What is the most likely diagnosis?

  1. Graves’ disease
  2. Toxic nodular goiter
  3. Hashimoto’s thyroiditis
  4. de Quervain’s thyroiditis
  5. Factitious thyrotoxicosis
Click here to compare your answer.


3. A 32-year-old woman is referred to you by her psychiatrist because of an enlarging goiter. The patient has a history of bipolar disease for the past 5 years and has been treated with lithium. Her medical history is otherwise unremarkable. Over the past year, she has gained 15 lb and constipation has been a problem. On physical examination, she is an obese woman with an obvious goiter. Examination of the neck shows a diffusely enlarged thyroid gland. Her deep tendon reflexes are delayed in the relaxation phase. Laboratory examination reveals a serum T4 level of 4.0 µg/dL and a serum TSH level of 45.3 µU/mL. What is the most likely diagnosis?
  1. Graves’ disease
  2. Toxic nodular goiter
  3. Hashimoto’s thyroiditis
  4. Lithium-induced hypothyroidism
  5. Factitious thyrotoxicosis
Click here to compare your answer.


4. A 65-year-old man presents with failure to thrive. He has lost 15 lb in the past month. He has a anorexia, lethargy, constipation, and cold intolerance. The thyroid gland is difficult to palpate and deep tendon reflexes have a delayed relaxation phase. Laboratory examination reveals a serum T4 level of 1.0 µg /dL, FT4 level of 0.1 ng/dL, and a TSH level of 0.4 µU/mL. What is the most likely diagnosis?

  1. Graves’ disease
  2. Toxic nodular goiter
  3. Hashimoto’s thyroiditis
  4. de Quervain’s thyroiditis
  5. Pituitary tumor
Click here to compare your answer.



Click here to read more about
Signs and Symptoms of Thyroid Disease

(Requires Adobe Acrobat Reader)




Check our archives to test your knowledge in other clinical signs:

Review of Clinical Signs Archives



Review of Clinical Signs main page


If you do not already have Acrobat Reader, simply click on the icon below, scroll down to the "Get the Free Acrobat Reader" heading and follow the instructions to install the program. Acrobat enables you to convert any document into an Adobe Portable Document Format (PDF) file for easy viewing.

Download Adobe Acrobat Reader

 

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj