<s>[INST] context: Thyrotoxicosis is a hypermetabolic state caused by elevated circulating levels of free T3 and T4 . most commonly caused by hyperfunctioning of thyroid gland, therefore it is often referred as hypehyroidism. However, in ceain conditions the oversupply is related to either excessive release of preformed thyroid hormone (e.g., in thyroiditis) or to an extrathyroidal source, rather than hyperfunctioning of gland. Disorder Associated with Thyrotoxicosis: Associated with Hypehyroidism Not associated with hypehyroidism - Primary: Diffuse hyperplasia (Graves' disease) Hyper functioning ("toxic") multinodular goiter Hyper functioning ("toxic") adenoma Iodine - induced hypehyroidism Neonatal thyrotoxicosis associated with maternal Grave's disease - Secondary: TSH-secreting pituitary adenoma (rare) Granulomatous (de Quervain) thyroiditis (painful) Subacute lymphocytic thyroiditis (painless) Struma ovarii (ovarian teratoma with ectopic thyroid) Facititious thyrotoxicosis (exogenous thyroxine intake) [/INST] question: Disorder associated with thyrotoxicosis but not associated with hypehyroidism is: | options: A: Graves disease B: Hyperfunctioning ("toxic") multinodular goiter C: Iodine-induced hypehyroidism D: De Quervain thyroiditis | answer: D </s>