12-16-2007, 02:44 AM
A 31-year-old female complains of a 2-month history of a 15-lb unintentional weight loss,
anxiety, and "feeling jittery." The neck examination is unremarkable. Physical examination
shows tachycardia and increased deep tendon reflexes. Thyroid-stimulating hormone (TSH) is
below 0.01. Total T4 is elevated. Whole-body radionuclide iodine scan shows only low uptake in
the region of the thyroid. Serum thyroglobulin levels are within the normal range. What is the
most likely diagnosis?
A. Graves' disease
B. Struma ovarii
C. Subacute thyroiditis
D. Lymphocytic thyroiditis
E. Thyrotoxicosis factitia
anxiety, and "feeling jittery." The neck examination is unremarkable. Physical examination
shows tachycardia and increased deep tendon reflexes. Thyroid-stimulating hormone (TSH) is
below 0.01. Total T4 is elevated. Whole-body radionuclide iodine scan shows only low uptake in
the region of the thyroid. Serum thyroglobulin levels are within the normal range. What is the
most likely diagnosis?
A. Graves' disease
B. Struma ovarii
C. Subacute thyroiditis
D. Lymphocytic thyroiditis
E. Thyrotoxicosis factitia