Thyroid Q 31-40 Practise mode

Q 31 ) A 35-year-old woman presents with a 1-week history of anterior neck pain, fatigue, and low-grade fever. Examination reveals a tender, firm thyroid gland. Labs show suppressed TSH, elevated free T4, elevated ESR, and low radioactive iodine uptake. What is the most likely diagnosis?

A. Graves' disease
B. Subacute granulomatous (De Quervain’s) thyroiditis
C. Hashimoto’s thyroiditis
D. Acute suppurative thyroiditis

B. Subacute granulomatous (De Quervain’s) thyroiditis

  • A. Graves’ disease: Hyperthyroidism with increased RAIU and non-tender thyroid.

  • B. Correct: De Quervain’s thyroiditis presents with:

    • Painful thyroid

    • Elevated ESR

    • Low RAIU (due to follicular damage)

    • Often preceded by viral illness

  • C. Hashimoto’s: Usually painless, chronic, with anti-TPO antibodies.

  • D. Suppurative thyroiditis: Painful but more toxic presentation, and may show abscess or fluctuance