USMLE Internal Medicine Review 12 11 Other Forms of Thyrotoxicosis

USMLE Internal Medicine Review 12 11 Other Forms of Thyrotoxicosis

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Let’s start our USMLE Review with Hypothyroidism and Hyperthyroidism from the Gold Standard USMLE Foundations of Medicine Audio Review program.

 

Play USMLE Audio MP3 12 11 Other Forms of Thyrotoxicosis Below

 

Begin 12 11 Other Forms of Thyrotoxicosis Transcription

We’ll now cover briefly 4 other forms of thyrotoxicosis significantly less common than Graves’ disease. These include toxic adenoma, toxic multinodular goiter, subacute or chronic thyroiditis and thyrotoxicosis factitia. Please select which of the 4 fits the following descriptions.

This illness is differentiated from other forms of thyrotoxicosis by a markedly suppressed radioiodine uptake with its symptoms normally spontaneously subsiding within weeks to months.

  • This is subacute or chronic thyroiditis.

This is a psychoneurotic disturbance caused by the patient ingesting large amounts of Thyroxine or thyroid hormone usually used for weight control?

  • Thyrotoxicosis factitia.

This disorder typically occurs in older patients’ clinical presentation including arrhythmia, tachycardia or heart failure, and sometimes weight loss, nervousness, weakness, tremors and sweating?

  • Toxic multinodular goiter. And this condition is also called Plummer’s disease.

Hypersecretion of T3 and T4 from lesions causes hyperthyroidism. The typical patient is over 40 with recent growth of a long-standing thyroid nodule.

  • This is toxic adenoma.

Student doctor please pause the tape and repeat 4 forms of thyrotoxicosis relatively common but far less so than Graves’ disease.

  • Forms of thyrotoxicosis, second in frequency only to Graves’ disease, include subacute or chronic thyroiditis, thyrotoxicosis factitia, toxic multinodular goiter and toxic adenoma or Plummer’s disease. We’ll finish our discussion of hypothyroidism and hyperthyroidism with a few specifics of the list of 5 rarer forms of thyrotoxicosis given earlier in the tape.

First, what is an epidemic of thyrotoxicosis which originated in the mid western United States and resulted from ingestion of neck trim thyroid tissue from slaughtered cattle?

  • Hamburger thyrotoxicosis. The USDA has now banned beef neck trim for human consumption.

Second, these cyst like fluid-filled structures produce chorionic gonadotropin which may induce thyroid hyperplasia?

  • Hydatidiform mole removal alleviates the problem.

Third, a syndrome in which a teratoma of the ovary contains hyperactive thyroid tissue resulting in mild thyrotoxicosis?

  • Stuma ovarii. The disease is curable by removal of the teratoma.

Fourth, a syndrome caused by either TSH secreting pituitary adenoma or nonneoplastic pituitary hypersecretion of TSH?

  • This is the syndrome of inappropriate TSH-secretion.

And fifth, body scan of this condition with Iodine 131 usually reveals areas of uptake distant from the thyroid, such as in the bone or lung?

  • Rarely does it present with hyperthyroidism. Thyroid Carcinoma. Treatment with large doses of radioiodine are used to destroy the metastatic deposits.

Student doctor please pause the tape and repeat 5 rarer forms of thyrotoxicosis alphabetically as presented.

  • Rarer forms of thyrotoxicosis include Hamburger Thyrotoxicosis, Hydatidiform mole, Struma Ovarii, Syndrome of inappropriate TSH secretion, and Thyroid Carcinoma.

****END OF TRANSCRIPTION****

 

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