Thyroid Disorders Clinical Case Flashcards

(45 cards)

1
Q

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?

A

Graves’ disease.

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2
Q

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?

A

Hypothyroidism.

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3
Q

A patient presents with a painless thyroid nodule and a history of radiation exposure in childhood. What should be suspected?

A

Thyroid cancer, likely papillary carcinoma.

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4
Q

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?

A

Primary hypothyroidism.

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5
Q

A patient presents with a rapidly enlarging thyroid mass, hoarseness, and dysphagia. What is the most likely diagnosis?

A

Anaplastic thyroid carcinoma.

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6
Q

A 60-year-old man presents with atrial fibrillation, weight loss, and tremors. What is the most likely endocrine cause?

A

Hyperthyroidism.

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7
Q

A 25-year-old woman presents with a painless, firm thyroid nodule. Fine-needle aspiration shows amyloid deposits. What is the likely diagnosis?

A

Medullary thyroid carcinoma.

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8
Q

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?

A

Secondary hypothyroidism (pituitary disease).

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9
Q

A patient presents with fever, tachycardia, delirium, and recent untreated hyperthyroidism. What is the diagnosis?

A

Thyroid storm.

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10
Q

A 30-year-old female presents with a history of hyperthyroidism followed by hypothyroidism after pregnancy. What is the likely diagnosis?

A

Postpartum thyroiditis.

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11
Q

A 40-year-old female presents with neck pain, fever, and hyperthyroid symptoms. ESR is elevated. What is the likely diagnosis?

A

De Quervain’s (subacute granulomatous) thyroiditis.

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12
Q

A patient with hyperthyroidism is started on carbimazole and develops a sore throat and fever. What is the most concerning complication?

A

Agranulocytosis.

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13
Q

A 50-year-old female presents with dysphagia and an enlarging neck mass. What is the next best investigation?

A

Fine-needle aspiration cytology (FNAC).

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14
Q

A patient with hyperthyroidism presents with proximal muscle weakness. What is the underlying mechanism?

A

Increased catabolism of muscle proteins due to excess thyroid hormones.

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15
Q

A 70-year-old male presents with weight loss, palpitations, and an irregularly irregular pulse. What endocrine disorder should be suspected?

A

Hyperthyroidism causing atrial fibrillation.

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16
Q

A 35-year-old woman presents with diffuse goiter, weight loss, and tremors. Which antibody test would confirm the diagnosis?

A

TSH receptor antibodies (TRAb) for Graves’ disease.

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17
Q

A newborn has a hoarse cry, macroglossia, and prolonged jaundice. What is the likely diagnosis?

A

Congenital hypothyroidism.

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18
Q

A patient presents with fatigue and constipation. Blood tests reveal anemia and elevated TSH. What is the most likely diagnosis?

A

Hypothyroidism with associated anemia.

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19
Q

A 30-year-old woman presents with a small, firm thyroid nodule. Serum calcitonin is elevated. What is the diagnosis?

A

Medullary thyroid carcinoma.

20
Q

A 45-year-old man presents with tachycardia, exophthalmos, and weight loss. What drug can be used to rapidly control symptoms?

A

Beta-blockers like propranolol.

21
Q

A 60-year-old female presents with a slow-growing, painless thyroid nodule. FNAC shows follicular cells. What is the next step?

A

Surgical excision to confirm follicular carcinoma diagnosis.

22
Q

A patient presents with hoarseness and a hard thyroid mass. What is the most likely diagnosis?

A

Thyroid malignancy invading the recurrent laryngeal nerve.

23
Q

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?

A

Drug-induced hyperthyroidism.

24
Q

A 28-year-old woman presents with tremors, weight loss, and insomnia. TSH is suppressed, and free T4 is elevated. What is the diagnosis?

A

Hyperthyroidism.

25
A patient with a history of Hashimoto’s thyroiditis develops a rapidly enlarging thyroid mass. What is the most likely diagnosis?
Thyroid lymphoma.
26
A 50-year-old woman presents with difficulty swallowing due to an enlarged thyroid. What imaging study is most appropriate?
Neck ultrasound.
27
A patient presents with an anterior neck swelling that moves with swallowing. What is the likely organ involved?
Thyroid gland.
28
A patient with hyperthyroidism is found to have a solitary 'hot' nodule on a thyroid scan. What is the likely diagnosis?
Toxic adenoma.
29
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.
30
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.
31
A patient presents with irritability, diarrhea, and heat intolerance. Which initial blood test should be done?
TSH and free T4 levels.
32
A 75-year-old woman presents with confusion, hypothermia, and bradycardia. What is the likely endocrine emergency?
Myxedema coma.
33
A patient presents with an enlarged thyroid gland and difficulty breathing. What is the likely complication?
Tracheal compression due to goiter.
34
A young woman presents with hyperthyroidism and a bruit over the thyroid gland. What is the likely diagnosis?
Graves’ disease.
35
A patient presents with a thyroid nodule and normal thyroid function tests. What is the next best step?
Fine-needle aspiration biopsy.
36
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).
37
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.
38
A pregnant woman is diagnosed with Graves’ disease. Which treatment is preferred?
Propylthiouracil (PTU) in the first trimester.
39
A patient with hyperthyroidism presents with osteoporosis. What is the underlying mechanism?
Increased bone resorption due to excess thyroid hormone.
40
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.
41
A 55-year-old woman with hyperthyroidism presents with severe eye symptoms. What is the preferred treatment?
Glucocorticoids for thyroid eye disease.
42
A patient presents with fatigue, anemia, and goiter. What is the likely underlying disorder?
Hypothyroidism with associated anemia.
43
A patient with hyperthyroidism undergoes thyroidectomy. What is the most serious postoperative complication?
Thyroid storm or hypocalcemia due to parathyroid damage.
44
A patient with hypothyroidism presents with depression. What is the best course of action?
Check TSH levels and adjust levothyroxine dose if needed.
45
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.