Goiter defination ,pathogenesis,classification.pptx

Lecture notes for medical students

1. Tips on using my ppt. You can freely download, edit, modify and put your name etc. Don’t be concerned about number of slides. Half the slides are blanks except for the title. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. At the end rerun the show – show blank> ask questions > show next slide. This will be an ACTIVE LEARNING SESSION x three revisions. Good for self study also. See notes for bibliography.

2. Introduction

3. Introduction Goiter/ Goitre Non specific term to indicate diffuse enlargement of thyroid gland.

4. Classification

5. Simple goiter Toxic goiter: Inflammatory goiter: Neoplastic goiter: Classification

6. Simple goiter: - No hormonal abnormalities and therefore no systemic effects. Either diffuse or nodular Classification

7. Simple goiter: 1.Physiological Pubertal ,Pregnancy 2.Diffuse hyperplastic 3. Multinodular goitre diffuse goiter often evolves into a nodular goiter Classification

8. Toxic goiter: Increased production of thyroid hormones. Diffuse (graves dis.) nodular single nodule toxic adenoma Plummer disease on the top of multinodular goiter. Classification

9. Classification Inflammatory goiter: 1. Autoimmune Chronic lymphocytic thyroiditis Hashimoto’s disease 2. Granulomatous : De Quervain’s thyroiditis 3. Fibrosing : Riedel’s thyroiditis 4. Infective Acute (bacterial thyroiditis,viral thyroiditis , ‘ subacute thyroiditis ’ Chronic ( tuberculous , syphilitic) 5. Other: Amyloid

10. Neoplastic goiter: Either benign (adenoma) or malignant Classification

11. Pathophysiology: TRH -TSH thyroid hormone axis

12. Pathophysiology: TRH -TSH thyroid hormone axis The thyroid gland is controlled byTSH secreted from the pituitary gland, Pituitary is stimulated by thyrotropin -releasing hormone (TRH) from the hypothalamus. TSH acts on TSH receptors located on the thyroid gland TSH permits growth, cellular differentiation, and thyroid hormone production and secretion by the thyroid gland. Serum thyroid hormones levothyroxine and triiodothyronine feed back to the pituitary, regulating TSH production

13. Pathophysiology: TRH -TSH thyroid hormone axis

14. Pathophysiology: TRH -TSH thyroid hormone axis Stimulation of the TSH receptors of the thyroid by TSH, TSH-receptor antibodies, or TSH receptor agonists, such as chorionic gonadotropin , may result in a diffuse goiter .  When a small group of thyroid cells, inflammatory cells, or malignant cells metastatic to the thyroid is involved, a thyroid nodule may develop.

15. Pathophysiology

16. Pathophysiology Stimulation of the thyroid gland by TSH, Inappropriate secretion from the anterior pituitary a microadenoma In response to a chronically low level of circulating thyroid hormones. 1. Dietary deficiency of iodine, 2 Goitrogens in food. 3. Defective hormone synthesis ( Dyshormonogenesis ) sporadic goitres .

17. Pathophysiology Somewhat surprisingly TSH levels are normal in simple goiter

18. GOITROGENS

19. DRUGS Anti-thyroid Cough medicines Sulfonamides Lithium Phenylbutazone PAS iodine Oral hypoglycemic agents GOITROGENS

20. FOOD Soybeans Millet Cassava Cabbage Excess iodine or lithium ingestion, which decrease release of thyroid hormone GOITROGENS

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22. Get this ppt in mobile

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