QuestionSBA
QuestionChoice
A thyroglossal cyst would be expected to move upwards on protrusion of the tongue. It would also usually not present with pain
32379
b
Thyroglossal cyst
QuestionChoice
De Quervain's thyroiditis is a self-limiting thyroiditis that is often preceded by a viral infection. It can present with a painful goitre and thyrotoxicosis in the initial stages. The thyrotoxicosis is often followed by a transient period of hypothyroidism before thyroid function returns to normal. The normal thyroid function likely indicates that the patient is reaching the end of the illness. Treatment is symptomatic, and there is usually no role for anti-thyroid medications such as carbimazole
32378
a
De Quervain’s thyroiditis
QuestionChoice
Grave's disease is the most common cause of thyrotoxicosis in the UK. It is an autoimmune condition that results in hyperthyroidism due to stimulatory autoantibodies against the thyroid-stimulating hormone (TSH) receptor. Normal thyroid function would exclude Grave's disease
32381
d
Grave's disease
QuestionChoice
Riedel thyroiditis usually presents as a painless thyroid mass that can be rapidly growing. It is characterised by a hardened, "woody" thyroid due to the replacement of the gland with fibrous tissue
32380
c
Riedel thyroiditis
QuestionChoice
Hodgkin's lymphoma usually presents with painless cervical or supra-clavicular lymphadenopathy that may be accompanied by B-symptoms (e.g. weight loss, night sweats, fevers)
32382
e
Hodgkin's lymphoma
QuestionComment
A patient that doesn't realise they have a problem... what a cheeky question
8615
User
subscriber
Yellow Zebras
QuestionComment
Would De Quervain’s thyroiditis not initially present thyrotoxic and have deranged TFTs?
9974
User
subscriber
Abrasion DNA
QuestionComment
so he's gone through the hyperthyroid phase, and the hypothyroid phase... and he didn't have any symptoms?
61753
User
subscriber
NewJeans
Concept
Chapter
# Summary

|                              | TSH  |   T3   |   T4   |
| :--------------------------: | :--: | :----: | :----: |
|    Primary hypothyroidism    | High |  Low   |  Low   |
|   Secondary hypothyroidism   | Low  |  Low   |  Low   |
| Sub-clinical hypothyroidism  | High | Normal | Normal |
|   Primary hyperthyroidism    | Low  |  High  |  High  |
|  Secondary hyperthyroidism   | High |  High  |  High  |
| Sub-clinical hyperthyroidism | Low  | Normal | Normal |

# References

[Click here for NICE CKS on hypothyroidism](https://cks.nice.org.uk/topics/hypothyroidism/)
1967
670
Patterns of Thyroid Disease
Topic
5
Endocrinology
Video
Concept
670
Patterns of Thyroid Disease
634
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Hyperthyroidism 2
Video
Concept
670
Patterns of Thyroid Disease
324
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Quesmed Tutorial: Medical Emergencies
Video
Concept
670
Patterns of Thyroid Disease
633
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Quesmed Tutorial: Thyroid Disease
Video
Concept
670
Patterns of Thyroid Disease
125
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Emergency management of thyrotoxic storm
Video
Concept
670
Patterns of Thyroid Disease
636
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Hypothyroidism 2
Video
Concept
670
Patterns of Thyroid Disease
707
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Hyperthyroidism 4
Video
Concept
670
Patterns of Thyroid Disease
706
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Patterns of Thyroid Disease 1
Video
Concept
670
Patterns of Thyroid Disease
637
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Subclinical Hypothyroidism
6476
De Quervain's thyroiditis is a self-limiting condition often triggered by viral infections, presenting with a painful goitre and transient thyroid dysfunction.
A 25-year-old man presents with a history of a painful neck lump. He reports noticing the lump over the last two weeks following an upper respiratory tract infection. He denies palpitations, tremors, weight loss or night sweats.

On examination, there is a smooth central neck lump that moves with swallowing but not on protrusion of the tongue.

Blood tests, including thyroid function, are normal.

Which of the following is the most likely diagnosis?
a