Thyroid nodules and goiter

Published on 02/03/2015 by admin

Filed under Endocrinology, Diabetes and Metabolism

Last modified 02/03/2015

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CHAPTER 36

Thyroid nodules and goiter

1. What is a goiter?

2. What causes goiter?

3. Describe the natural history of diffuse nontoxic goiter.

Simple goiter tends to become multinodular over time. The nodules are heterogeneous in both morphology and function. Autonomous function, defined as TSH-independent production and secretion of thyroid hormone, can evolve. Supplementation programs in iodine-deficient populations clearly decrease the incidence of cretinism and goiter but have also increased the incidence of iodine-associated hyperthyroidism. This Jod-Basedow hyperthyroidism is more likely to occur in older people with autonomous adenomatous goiters. In the United States, this form of hyperthyroidism usually results from iodine excess due to radiographic contrast agents or medications rich in iodine. The thyroid hormone excess may be transient and may not require treatment. When it is severe, antithyroid medications and thyroidectomy can be used. Iodine excess usually precludes radioiodine as a treatment option.

4. How does lithium affect thyroid function?

5. Describe the mechanism by which lithium produces goiter and hypothyroidism.

6. How common are thyroid nodules?

7. List the differential diagnosis for a thyroid nodule.

8. Can the nature of a thyroid nodule be determined from family history?

9. Do personal history and physical examination help define the nature of a thyroid nodule?

10. How are most thyroid cancers discovered?

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