Question 1

What is diffuse thyrotoxic goiter?

Accepted Answer

Graves' disease is an autoimmune disease - one in which the immune system attacks certain tissues - that causes overactivity of the thyroid gland (hyperthyroidism).

Question 2

What are the risk factors for diffuse thyrotoxic goiter?

Accepted Answer

Located in the front of the neck just below the larynx (voicebox), the thyroid gland is an important organ of the endocrine system. The thyroid secretes the hormones thyroxine (T4) and triiodothyronine (T3), which control body metabolism. Regulation of metabolism is critical in controlling mood, weight and mental and physical energy levels. Thyroid disorders caused by overproduction of thyroid hormones are called hyperthyroidism, and underproduction of these hormones is known as hypothyroidism. Graves' disease is the most common cause of hyperthyroidism.

Question 3

What are the symptoms of diffuse thyrotoxic goiter?

Accepted Answer

• Protruding eyes (less common in children) • Weight loss • Increased appetite • Nervousness • Restlessness • Heat intolerance • Increased sweating • Fatigue • Muscle weakness • Double vision • Eye irritation • Breast enlargement in men (possible) • Tremor • Frequent bowel movements • Menstrual irregularities in women • Goiter (possible) Signs and tests Physical examination shows an increased heart rate. Examination of the neck may show thyroid enlargement or goiter. • Serum TSH is decreased • Serum T3, free T4 are elevated • Radioactive iodine uptake is usually high This disease may also alter the following test results: • TSI • Orbit CT scan

Question 4

How is diffuse thyrotoxic goiter treated?

Accepted Answer

The purpose of treatment is to control the overactivity of the thyroid gland. Beta-blockers such as propranolol are often used to treat symptoms of rapid heart rate, sweating, and anxiety until the hyperthyroidism is controlled. Hyperthyroidism is treated with antithyroid medications, radioactive iodine or surgery. Both radiation and surgery result in the need for lifelong use of replacement thyroid hormones, because these treatments destroy or remove the gland. The eye problems related to Graves' disease usually resolve when the hyperthyroidism is effectively treated with medications, radiation or surgery.

Question 5

What is the outlook for diffuse thyrotoxic goiter?

Accepted Answer

For most people, Graves' disease responds well to treatment. However, thyroid surgery or radioactive iodine will sometimes cause hypothyroidism, which can lead to weight gain, depression and mental and physical sluggishness. Antithyroid medications can also have serious side effects.

Question 6

What are the complications of diffuse thyrotoxic goiter?

Accepted Answer

• Eye problems associated with the disease (called Graves' ophthalmopathy or exophthalmos) • Cardiac Complications including rapid heart rate, congestive heart failure (especially in the elderly) and atrial fibrillation • Thyroid crisis or storm, a severe worsening of the symptoms of overactivity of the thyroid gland • Increased risk for osteoporosis • Inadequate levels of thyroid hormone medications following surgery or radiation, leading to fatigue, elevated cholesterol levels, mild weight gain, depression and mental and physical sluggishness • Complications related to surgery, including visible scarring of the neck and hoarseness due to damage of the nerve to the voicebox, and low…

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