Sandbox:ddx graves: Difference between revisions
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{{familytree/start}} | {{familytree/start}} | ||
{{familytree | {{familytree | | | | | | | | | | | | | | A01 | | | | | |A01=Suspected Graves' disease}} | ||
{{familytree | {{familytree | | | | | | | | | | | | | | |!| | | | | | | | }} | ||
{{familytree | {{familytree | | | | | | | | | | | | | | B01 | | | | | |B01=Measure serum TSH and free T4}} | ||
{{familytree | {{familytree | | | | | |,|-|-|-|v|-|-|-|-|^|-|-|-|-|v|-|-|-|.| }} | ||
{{familytree | {{familytree | | | | | C01 | | C02 | | | | | | | | C03 | | C04 | | | |C01=Normal TSH & free T4|C02=↓ TSH & ↑ free T4|C03=↓ TSH & Normal free T4|C04= Normal or ↑ TSH & ↑ free T4}} | ||
{{familytree | {{familytree | | | | | |!| | | |!| | | | | | | | | |!| | | |!| }} | ||
{{familytree | {{familytree | | | | | D01 | | D02 | | | | | | | | D03 | | D04 | | | |D01= Hyperthyroidism ruled out|D02=Hyperthyrodism|D03=Measure free T3|D04=TSH secreting pituitary tumor,<br> Thyroid hormone resistance<br> or Assay interference }} | ||
{{familytree | {{familytree | | | | | | | | | |!| | | | | | | | | |!| | | | || | | }} | ||
{{familytree | {{familytree | | | | | | | | | E03 | | | | | | |,|-|^|-|.| | |E03=Measure TSH receptor antibodies }} | ||
{{familytree | {{familytree | | | | | | | | | |!| | | | | | | F01 | | F02 | |F01=↑ free T3|F02=Normal free T3 }} | ||
{{familytree | | | | | | |,|-|-|-| | {{familytree | | | | | | | |,|-|^|-|.| | | | | |!| | | |!| |}} | ||
{{familytree | | | | | | | {{familytree | | | | | | | G01 | | G02 | | | | G03 | | G04 | |G01=Present|G02=Absent|G03=T3 Toxicosis|G04=Sub-clinical Hyperthyrodism}} | ||
{{familytree | | | | | | | |!| | | |!| | | | | | | | | |!| | | | }} | |||
{{familytree | | | | | | | H01 | | H02 | | | | | | | | H03 | |H01='''Graves' Disease|H02=Assess radioiodine uptake<br>obtain radionuclide scan<br> or both|H03=Evolving Graves' disease<br>Evolving toxic nodular goiter<br>Excess thyroid hormone intake<br>Non thyroidal illness }} | |||
{{familytree | | | | | | | | | | | |!| | | | | | | | | | | | | | }} | |||
{{familytree | | | | | | | |,|-|-|-|+|-|-|-|.| | | | | | | | | | }} | |||
{{familytree | | | | | | | I01 | | I02 | | I03 | | | | | | | | |I01=Homogeneous<br>increased uptake|I02=Patchy uptake<br>or single nodule|I03=Low or no uptake}} | |||
{{familytree | | | | | | | |!| | | |!| | | |!| | | | | | | | | | }} | |||
{{familytree | | | | | | | J01 | | J02 | | J03 | | | | | | | | |J01=Graves' disease|J02=Toxic nodular goiter|J03=Subacute thyroiditis<br>Excess thyroid hormone intake<br>HCG secreting tumor}} | |||
{{familytree/end}} | {{familytree/end}} |
Revision as of 18:06, 19 December 2016
Suspected Graves' disease | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Measure serum TSH and free T4 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Normal TSH & free T4 | ↓ TSH & ↑ free T4 | ↓ TSH & Normal free T4 | Normal or ↑ TSH & ↑ free T4 | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Hyperthyroidism ruled out | Hyperthyrodism | Measure free T3 | TSH secreting pituitary tumor, Thyroid hormone resistance or Assay interference | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Measure TSH receptor antibodies | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
↑ free T3 | Normal free T3 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
Present | Absent | T3 Toxicosis | Sub-clinical Hyperthyrodism | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Graves' Disease | Assess radioiodine uptake obtain radionuclide scan or both | Evolving Graves' disease Evolving toxic nodular goiter Excess thyroid hormone intake Non thyroidal illness | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Homogeneous increased uptake | Patchy uptake or single nodule | Low or no uptake | |||||||||||||||||||||||||||||||||||||||||||||||||||||
Graves' disease | Toxic nodular goiter | Subacute thyroiditis Excess thyroid hormone intake HCG secreting tumor | |||||||||||||||||||||||||||||||||||||||||||||||||||||