Case Discussion 6.8.1398

What are FNA changes after iodine therapy?

Grave’s or toxic MNG?

Risk of cancer in follow up of graves disease or toxic MNG?

Risk of cancer in follow up after I131 therapy?

How suspicious thyroid nodules should be managed? 

Diagnosis of thyrotoxicosis ethiology

• If the diagnosis of hyperthyroidism is not apparent based on the clinical presentation and initial biochemical evaluation, diagnostic testing is indicated and can include, depending on available expertise and resources:

      (1)determination of the radioactive iodine uptake (RAIU)

      (2)measurement of thyroidal blood flow on ultrasonography

      (3) measurement of TRAb

• The choice of initial diagnostic testing depends on cost, availability, and local expertise.
• In the setting of overt thyrotoxicosis, newer TRAb binding and bioassays

              have a sensitivity of 96–97% and a specificity of 99% for G