Goiers

Question 1

Explain the patho of a goiter?

Answer 1

The thyroid gland is not producing thyroid hormone, so because of feedback loops, TSH levels increase and cause hypertrophy and hyperplasia of the thyroid follicular cells and the thyroid gland enlarges.

Question 2

What are the two types of goiters?

Answer 2

Diffuse non toxic and multi nodular

Question 3

What are the two distributions of a diffuse non toxic goiter?

Answer 3

Endemic and sporadic

Question 4

Explain the cause of endemic goiters and their patho?

Answer 4

Endemic goiters are caused by there not being enough iodide. Iodide is responsible for thyroid hormone synthesis, so thyroid hormone levels are low and TSH is high.

Question 5

What are two goitrogens she wants us to know that put someone at risk for a goiter?

Answer 5

Cassava root and brassicaceae

Question 6

What is the thyroid hormone level status in patients with diffuse goiters and why? Also, what are the clinical symptoms usually due to and why?

Answer 6

Clinically euthyroid, meaning the compensatory TSH response is producing enough thyroid hormone to be normal.
Any clinical symptom is due to mass effect from the thyroid being larger, such as hoarseness, dysphagia, and SVC compression

Question 7

What gender is more commonly affected by simple goiters?

Answer 7

Female

Question 8

If simple goiters continue their course long enough, what will they become?

Answer 8

Multinodular goiters

Question 9

The main clinical symptoms of a multinodular goiter manifest because of what?

Answer 9

Mass effect. These babies can be huge and start compressing several things.

Question 10

What can a radioiodine scan tell us and how can this be helpful?

Answer 10

It can tell us whether a nodule is hot or cold. Both are more commonly benign, but cold nodules have a slightly higher risk to be malignant.

Question 11

If we think we have a malignant nodule, what are the two best tests for that work up?

Answer 11

Fine needle aspiration and US