Differential Diagnoses – Hyperthyroidism (Thyrotoxicosis)

by Carlo Raj, MD

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    On this table, we’ll take a look at differentials of your hyperthyroidism. Pretty much repetitive of the algorithm that we saw earlier, however, this time in a table format. However you wish to learn, make sure that you know these important differentials. We’ll divide this into the following columns and I’ll walk you through this: causes, mechanism, thyroid exam and the radioactive iodine and initially, it will be hyperthyroidism with a normal or high radioactive iodine uptake. First, autoimmune thyroid diseases will be our-our organization or our first category. Hashitoxicosis, what does that mean? Remember, with Hashimoto, I think we’re clear now that initially there is every possibility with that lymphocytic infiltration of the thyroid gland in which your colloid is being destroyed in releasing T3,T4 presenting how? Initially, with hyperthyroidism. That’s my topic for this entire table. This is then called Hashitoxicosis, how appropriate? Initially, you are going to have those autoimmune or antibodies that are then attacking maybe the thyroid globulin or maybe it is then attacking the peroxidase, those are the most common ones. It could really have destruction anywhere. Thyroid exam, you’re going to feel a goiter and here, initially, you’re going to find increased radioactive iodine uptake. In Graves’ disease, this is your TSI that we talked about plenty of a diffused goiter and here it will be a diffused radioactive iodine uptake. If you take a look at a scintigram here, take a look at the thyroid gland and you see these two lobes that are “lit up” quote and quote that’s because the entire thyroid gland diffusely is taking up radioactive iodine uptake or radioactive iodine. The second organization will be autonomous thyroid tissue. Uptake may be a low, if recent iodine load led to iodine induced hyperthyroidism. Let’s take a look. We...

    About the Lecture

    The lecture Differential Diagnoses – Hyperthyroidism (Thyrotoxicosis) by Carlo Raj, MD is from the course Thyroid Gland Disorders.

    Included Quiz Questions

    1. Activating gene mutation
    2. Presents of anti-thyroid antibodies
    3. Goiter
    4. Hyperthyroidism
    5. Increased radioactive iodine uptake
    1. Grave's disease
    2. Hashitoxicosis
    3. Toxic adenoma
    4. Pituitary tumor
    5. Choriocarcinoma
    1. Toxic multinodular goiter
    2. Pituitary adenoma
    3. Grave's disease
    4. Hashitoxicosis
    5. Choriocarcinoma
    1. Increased hCG stimulates thyroid
    2. TSI
    3. Anti-thyroid antibodies
    4. Increased TSH
    5. Activating gene mutation

    Author of lecture Differential Diagnoses – Hyperthyroidism (Thyrotoxicosis)

     Carlo Raj, MD

    Carlo Raj, MD

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    Omission of subsequent investigaitons
    By Hamed S. on 19. February 2017 for Differential Diagnoses – Hyperthyroidism (Thyrotoxicosis)

    Good table but a discussion of subsequent investigations to further characterise the nodule is warranted. For example following up a cold nodule with U/S guided FNA . The algorithm wasn't took clear for example starting with thyroid function test, followed by iodine uptake and further imaging/biopsy