Losing Weight

Description

Mind Map on Losing Weight, created by Menna Emam on 19/11/2017.
Menna Emam
Mind Map by Menna Emam, updated more than 1 year ago
Menna Emam
Created by Menna Emam almost 7 years ago
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Resource summary

Losing Weight
  1. Laila
    1. presented with
      1. GOITER
        1. Is an enlargement of the thyroid gland.
          1. Can be physiological due to increased demand of the thyroid hormone as in puberty, or due to mali- gnant disease which needs urgent diagnosis and treatment
            1. causes
              1. Simple (non-toxic) goitre
                1. Simple hyperplastic goitre
                  1. Multinodular goitre
                2. Neoplastic goitre
                  1. Malignant
                    1. Papillary
                      1. Follicular
                        1. Anaplastic
                          1. Lymphoma
                            1. Medullary
                    2. Benign
                      1. Adenoma
                    3. Autoimmune
                      1. Hashimoto's thyroidits
                      2. Inflammatory
                        1. de Quervain's thyroditis
                          1. Riedel's thyroiditis
                        2. Toxic goitre
                          1. Graves' disease
                            1. Toxic nodule
                              1. Toxic multinodular goitre
                    4. Later diagnosed with thyrotoxicosis
                      1. Graves' Disease
                        1. Definition
                          1. Graves disease is the most common cause of endogenous hyperthyroidism.
                          2. Pathogenesis
                              1. Graves disease is an autoimmune disorder in which a variety of antibodies may be present in the serum, including antibodies to the:
                                1. Autoantibodies to the TSH receptor are central to disease pathogenesis and they include:
                                  1. Thyroid-stimulating immunoglobulin
                                    1. Thyroid growth-stimulating immunoglobulins (TGIs)
                                      1. TSH-binding inhibitor immunoglobulins (TBII)
                                  2. TSH receptor
                                    1. Thyroid peroxisomes
                                      1. Thyroglobulin
                                2. Morphology
                                  1. Diffusely hyperplastic thyroid in a case of Graves disease. The follicles are lined by tall, columnar epithelium. The crowded, en- larged epithelial cells pro- ject into the lumens of the follicles. These cells actively resorb the colloid in the centers of the follicles, resulting in the scalloped appearance of the edges of the colloid.
                                    1. Hyperemic “juicy” appearance. The gland is usually smooth and soft, and its capsule is intact.
                                    2. Risk factors
                                      1. occurs more often in women, mostly 20-40 years old
                                      2. Characterised by a triad of
                                        1. Thyrotoxicosis, caused by a diffusely enlarged, hyperfunctional thyroid, is present in all cases.
                                          1. An infiltrative ophthalmopathy with resultant exophthalmos is noted in as many as 40% of patients.
                                            1. A localized, infiltrative dermopathy (sometimes designated pretibial myxedema) is seen in a minority of cases.
                                        2. Laboratory Findings
                                          1. Elevated serum free T4 and T3
                                            1. depressed serum TSH
                                              1. radioactive iodine uptake is increased
                                                1. Because of ongoing stimulation of the thyroid follicles by thyroid-stimulating immunoglobulins
                                          2. Treatment
                                            1. 1- Propranolol
                                              1. 2- Thiourea drugs (Antithyroid drugs)
                                                1. 3- Iodinated contrast agents
                                                  1. 4- Radioactive iodine
                                                    1. 5- Thyroid surgery
                                                      1. Laila finally required
                                                        1. Thyroidectomy
                                                          1. Indications
                                                            1. Developmental Thyroid Abnormalities
                                                              1. Hyperthyroidism
                                                                1. Thyroiditis
                                                                  1. Thyroid Nodules
                                                            2. could be
                                                              1. either
                                                                1. Subtotal thyroidectomy: Bilateral removal of >50% of each lobe and an isthmusectomy
                                                                2. or
                                                                  1. Total thyroidectomy: Complete removal of both thyroid lobes, isthmus, and pyramidal lobe
                                              2. Hyperthyrodism
                                                  1. Signs & symptoms
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