Topic: Tumors of Thyroid, Adrenal Glands
Question: 35 year old female, presented with history of swelling of 5 x 4 cm Since, four months in front of the neck, which moves with deglutition, with the loss of weight in spite of increased appetite. She is irritable with lack of sleep and oligomenorrhea. On examination tachycardia noted, patient looks anxious with the lid lag and staring look. Write your probable diagnosis. Describe how you would investigate and manage.
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probable diagnosis is Graves’ disease with diffuse toxic goiter.
Investigations:
– Thyroid function tests:
– T3: Elevated, normal range 60-180 ng/dL
– T4: Elevated, normal range 5-12 μg/dL
– TSH: Suppressed, normal range 0.5-5 μU/mL
– Thyroid stimulating immunoglobulin: Elevated, normal <1.3 IU/L
– Ultrasound neck: Diffuse enlargement of both thyroid lobes with increased vascularity
– Radioiodine uptake scan: Diffusely increased uptake, usually 40-60% at 24 hours (normally 10-30%)
Management:
1. Antithyroid drugs:
– Methimazole 10-40 mg/day (starting dose 10-20 mg/day) or
– Carbimazole 20-60 mg/day (starting dose 20-40 mg/day),
– Target is to attain euthyroid state
2. Beta blocker:
– Propranolol 10-40 mg thrice daily for symptom control
3. Definitive treatment after attaining euthyroid state:
– Radioactive iodine ablation: 150-200 μCi/gm of thyroid tissue
– Thyroidectomy
4. Supportive care: Hydration, nutritional supplementation
5. Monitor thyroid function tests every 4-6 weeks to adjust antithyroid drug doses.
6. Long term follow up for recurrence after stopping medications.
6. Patient education on disease, treatment compliance, regular monitoring of thyroid levels.
7. Address ophthalmopathy if present with lubricants, steroids, immunosuppression.
8. Manage cardiovascular effects, periodic evaluation for atrial fibrillation.
The key points are confirming the diagnosis with lab tests and imaging, starting medications to make the patient euthyroid, then definitive treatment with radioactive iodine or surgery, along with long term monitoring and supportive care
Medicivils Medical Science Optional Test Series: Better Than UPSC Medico? Introduction The UPSC Civil Services Examination (CSE) is one of the most competitive exams in the world. The Medical Science optional is a popular choice for many candidates, as it covers a wide range of topics that are relevant to the UPSC syllabus. There are many different test series available for the Medical Science optional, but one of the most popular is the Medicivils test series. Medicivils is a coaching institute that specializes in the Medical Science optional, and their test series is known for its high quality and comprehensive coverage of the syllabus. In this article, we will compare the Medicivils Medical Science Optional Test Series to the UPSC Medico Test Series, and discuss why Medicivils is the better choice for UPSC CSE aspirants. Quality of Questions The quality of the questions in the Medicivils test series is very high. The questions are well-drafted and cover a wide range of topics from the syllabus. The questions are also challenging enough to test the candidates’ knowledge and understanding of the subject. The UPSC Medico test series, on the other hand, has been criticized for the quality of its questions. Some candidates have complained that the questions are too repetitive and do not adequately cover the syllabus. Comprehensiveness The Medicivils test series covers the entire Medical Science syllabus in great detail. The test series includes full-length tests, subject-wise tests, and topic-wise tests. This ensures that the candidates are thoroughly prepared for all aspects of the exam. The UPSC Medico test series, on the other hand, is not as comprehensive. The test series does not cover all of the topics in the syllabus in equal detail. Additionally, the test series does not include any topic-wise tests. Model Answer Sheets The Medicivils test series provides high-quality model answer sheets for all of its tests. The model answer sheets are written by experienced faculty members and provide detailed explanations for all of the questions. The UPSC Medico test series, on the other hand, does not provide model answer sheets for all of its tests. Even for the tests that do have model answer sheets, the quality is often not up to par. Personal Mentorship Medicivils offers personal mentorship to all of its students. The students can get their papers evaluated by experienced faculty members and receive personalized feedback. This helps the students to identify their strengths and weaknesses and to improve their performance. The UPSC Medico test series does not offer personal mentorship to its students. The students do not have the opportunity to get their papers evaluated by experienced faculty members and receive personalized feedback. Video Solutions Medicivils provides video solutions for all of its subject-wise tests. The video solutions are taught by experienced faculty members and provide detailed explanations for all of the questions. The UPSC Medico test series does not provide video solutions for its tests. Evaluation Medicivils evaluates the students’ papers within 7 days. The students’ papers are evaluated by experienced faculty members and they receive a detailed evaluation report. The UPSC Medico test series takes longer to evaluate the students’ papers. The students often have to wait for 10-15 days to receive their evaluation reports. Conclusion Overall, the Medicivils Medical Science Optional Test Series is the better choice for UPSC CSE aspirants. The Medicivils test series offers high-quality questions, comprehensive coverage of the syllabus, model answer sheets, personal mentorship, video solutions, and prompt evaluation. The UPSC Medico test series, on the other hand, has been criticized for the quality of its questions, lack of comprehensive coverage of the syllabus, lack of model answer sheets, lack of personal mentorship, lack of video solutions, and delayed evaluation. If you are serious about cracking the UPSC CSE with the Medical Science optional, then the Medicivils Medical Science Optional Test Series is the best choice for you.
