Hyperactive

Endocrine System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This 48-year-old woman complains of a constellation of symptoms which form an almost textbook presentation of thyrotoxicosis; examination reinforces this impression, while also revealing a diffuse, non-tender goiter and ophthalmic signs.\n \nBiochemistry confirms the presence of hyperthyroidism by revealing decreased levels of serum thyroid stimulating hormone (TSH), along with elevated total T3 and free T4 fractions.\n\nThe key causes of hyperthyroidism include Graves\u2019 disease (GD), toxic multinodular goiter, toxic adenoma, and thyroiditis; in this specific case though, the first of these appears to be the overwhelming possibility.\n\nFor thoroughness, a thyroid ultrasound should be ordered, to both confirm the absence of nodules, and also establish a baseline, as individuals with GD have a higher risk of thyroid cancer vis-a-vis the general population.\n\nSonography in turn reveals a diffusely enlarged and hypoechogenic gland, with increased vascularity and no nodules; when considered alon"}]}

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