Thyroid Disorders Clinical Case Flashcards
A 30-year-old woman presents with weight loss, palpitations, and heat intolerance. Examination reveals a diffuse goiter and exophthalmos. What is the likely diagnosis?
Graves’ disease.
A 55-year-old male presents with fatigue, weight gain, and constipation. Examination reveals coarse skin, bradycardia, and delayed deep tendon reflexes. What is the likely diagnosis?
Hypothyroidism.
A patient presents with a painless thyroid nodule and a history of radiation exposure in childhood. What should be suspected?
Thyroid cancer, likely papillary carcinoma.
A 40-year-old woman presents with fatigue, dry skin, and cold intolerance. TSH is elevated, and free T4 is low. What is the diagnosis?
Primary hypothyroidism.
A patient presents with a rapidly enlarging thyroid mass, hoarseness, and dysphagia. What is the most likely diagnosis?
Anaplastic thyroid carcinoma.
A 60-year-old man presents with atrial fibrillation, weight loss, and tremors. What is the most likely endocrine cause?
Hyperthyroidism.
A 25-year-old woman presents with a painless, firm thyroid nodule. Fine-needle aspiration shows amyloid deposits. What is the likely diagnosis?
Medullary thyroid carcinoma.
A 65-year-old woman presents with lethargy, hair thinning, and weight gain. TSH is normal, but free T4 is low. What is the diagnosis?
Secondary hypothyroidism (pituitary disease).
A patient presents with fever, tachycardia, delirium, and recent untreated hyperthyroidism. What is the diagnosis?
Thyroid storm.
A 30-year-old female presents with a history of hyperthyroidism followed by hypothyroidism after pregnancy. What is the likely diagnosis?
Postpartum thyroiditis.
A 40-year-old female presents with neck pain, fever, and hyperthyroid symptoms. ESR is elevated. What is the likely diagnosis?
De Quervain’s (subacute granulomatous) thyroiditis.
A patient with hyperthyroidism is started on carbimazole and develops a sore throat and fever. What is the most concerning complication?
Agranulocytosis.
A 50-year-old female presents with dysphagia and an enlarging neck mass. What is the next best investigation?
Fine-needle aspiration cytology (FNAC).
A patient with hyperthyroidism presents with proximal muscle weakness. What is the underlying mechanism?
Increased catabolism of muscle proteins due to excess thyroid hormones.
A 70-year-old male presents with weight loss, palpitations, and an irregularly irregular pulse. What endocrine disorder should be suspected?
Hyperthyroidism causing atrial fibrillation.
A 35-year-old woman presents with diffuse goiter, weight loss, and tremors. Which antibody test would confirm the diagnosis?
TSH receptor antibodies (TRAb) for Graves’ disease.
A newborn has a hoarse cry, macroglossia, and prolonged jaundice. What is the likely diagnosis?
Congenital hypothyroidism.
A patient presents with fatigue and constipation. Blood tests reveal anemia and elevated TSH. What is the most likely diagnosis?
Hypothyroidism with associated anemia.
A 30-year-old woman presents with a small, firm thyroid nodule. Serum calcitonin is elevated. What is the diagnosis?
Medullary thyroid carcinoma.
A 45-year-old man presents with tachycardia, exophthalmos, and weight loss. What drug can be used to rapidly control symptoms?
Beta-blockers like propranolol.
A 60-year-old female presents with a slow-growing, painless thyroid nodule. FNAC shows follicular cells. What is the next step?
Surgical excision to confirm follicular carcinoma diagnosis.
A patient presents with hoarseness and a hard thyroid mass. What is the most likely diagnosis?
Thyroid malignancy invading the recurrent laryngeal nerve.
A 40-year-old male presents with thyroid enlargement and symptoms of hyperthyroidism. There is a history of lithium use. What is the likely diagnosis?
Drug-induced hyperthyroidism.
A 28-year-old woman presents with tremors, weight loss, and insomnia. TSH is suppressed, and free T4 is elevated. What is the diagnosis?
Hyperthyroidism.
A patient with a history of Hashimoto’s thyroiditis develops a rapidly enlarging thyroid mass. What is the most likely diagnosis?
Thyroid lymphoma.
A 50-year-old woman presents with difficulty swallowing due to an enlarged thyroid. What imaging study is most appropriate?
Neck ultrasound.
A patient presents with an anterior neck swelling that moves with swallowing. What is the likely organ involved?
Thyroid gland.
A patient with hyperthyroidism is found to have a solitary ‘hot’ nodule on a thyroid scan. What is the likely diagnosis?
Toxic adenoma.
A 45-year-old woman presents with a firm, irregular thyroid mass and cervical lymphadenopathy. What is the most likely diagnosis?
Thyroid carcinoma with metastasis.
A 35-year-old woman presents with a painless goiter and signs of hypothyroidism. TPO antibodies are elevated. What is the diagnosis?
Hashimoto’s thyroiditis.
A patient presents with irritability, diarrhea, and heat intolerance. Which initial blood test should be done?
TSH and free T4 levels.
A 75-year-old woman presents with confusion, hypothermia, and bradycardia. What is the likely endocrine emergency?
Myxedema coma.
A patient presents with an enlarged thyroid gland and difficulty breathing. What is the likely complication?
Tracheal compression due to goiter.
A young woman presents with hyperthyroidism and a bruit over the thyroid gland. What is the likely diagnosis?
Graves’ disease.
A patient presents with a thyroid nodule and normal thyroid function tests. What is the next best step?
Fine-needle aspiration biopsy.
A 25-year-old woman presents with palpitations, weight loss, and a diffusely enlarged thyroid. What is the first-line treatment?
Carbimazole or propylthiouracil (PTU).
A 50-year-old man with long-standing multinodular goiter develops hoarseness. What is the most concerning possibility?
Thyroid malignancy invading the recurrent laryngeal nerve.
A pregnant woman is diagnosed with Graves’ disease. Which treatment is preferred?
Propylthiouracil (PTU) in the first trimester.
A patient with hyperthyroidism presents with osteoporosis. What is the underlying mechanism?
Increased bone resorption due to excess thyroid hormone.
A patient with subacute thyroiditis presents with neck pain and fever. What is the expected thyroid function test result?
Low TSH, high free T4, and high ESR.
A 55-year-old woman with hyperthyroidism presents with severe eye symptoms. What is the preferred treatment?
Glucocorticoids for thyroid eye disease.
A patient presents with fatigue, anemia, and goiter. What is the likely underlying disorder?
Hypothyroidism with associated anemia.
A patient with hyperthyroidism undergoes thyroidectomy. What is the most serious postoperative complication?
Thyroid storm or hypocalcemia due to parathyroid damage.
A patient with hypothyroidism presents with depression. What is the best course of action?
Check TSH levels and adjust levothyroxine dose if needed.
A 40-year-old woman presents with palpitations, weight loss, and heat intolerance. TSH is suppressed, and free T4 is high. What is the diagnosis?
Primary hyperthyroidism.
