<prompt> False statement regarding Grave;s diseaseGoiter is diffuse and vascularCardiac failure is commonRemissions and exacerbation are not infrequentHyperophyhyperplasia is due to TSH-RA bs  <response>: Graves disease Diffuse Toxic Goiter MC cause of hypehyroidism, caused by stimulatory autoantibodies to TSH-R Auto immune disease with strong familial predisposition More common in females with peak incidence between 40-60 years Characterized by thyrotoxicosis, diffuse goiter extrathyroidal conditions ophthalmopathy, dermopathy, thyroid acropachy and gynecomastia Clinical features Hypehyroid symptoms heat intolerance, increased sweating and thirst, weight loss despite adequate caloric intake. Symptoms of adrenergic stimulation palpitations, nervousness, fatigue, emotional liability, hyperkinesis and tremors MC GI symptom is increased frequency of bowel movements and diarrhoea Female patients often develop amenorrhoea, decreased feility and increased incidence of miscarriage Children experience rapid growth with early bone maturation. Older patients present with CVS complications AD CHF Ove Cardiac failure presents in only 6-19 Weight loss, facial flushing, warm and moist skin, tachycardia, cutaneous vasodilation, collapsing pulse is seen on examination A fine tremor, muscle wasting and proximal muscle group weakness with hyperactive tendon reflexes often are present Overlying bruit or thrill at upper pole due to increased vascularity Loud venous gun in supraclavicular space Ophthalmopathy Orbital proptosis occurs in 50 dermopathy in 1-2 Dermopathy is characterized by deposition of glycosaminoglycans leading to thickened skin in pretibial region and dorsum of foot pretibial myxedema Gynecomastia is common in young men. Rare bony involvement leads to subperiosteal bone formation and swelling in metacarpals thyroid acropachy Ref : schwazs principle of surgery 10th edition Pgno :1531 