Mind map

Leila was losing weight

me - English

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her glands looked a bit swollen in her neck.
- she was always hungry & lost weight
  - Cancer
    - Eating disorders
      - Malabsorption
        diabetes
        depression
        stress
  - signs and symptoms of Hyperthyroidism
- Dr Kamal ordered a fullset of thyroid function tests (TFTs
  - wrote on the lab slip his clinical diagnosis of hyperthyroidism
    - He decided to order an antithyroid peroxidase (aTpo)test and a fullblood examination (FBE).
      - they could then decide on the best management plan'
        relapsed, had to undergo thyroidectomy
        A thyroidectomy may be recommended for conditions such as:
        Thyroid cancer
        Noncancerous enlargement of the thyroid (goiter).
        Overactive thyroid (hyperthyroidism).
        Overactive thyroid (hyperthyroidism).
        Treatment
    - types
      - Diffuse toxic goiters- Graves disease
        An immunoglobulin called thyroid-stimulating immunoglobin (TSI) found in the blood of all patients; TSI binds to the TSH receptor and induce TSH-like effects; TSI effects persist longer than TSH (up to 12 hrs vs. 1 hr respectively) Plasma level of TSH is suppressed due to the high level of thyroid hormones
        females 20-40
        autoimmune
        Diagnosis
        Thyroid auto antibodies
        TSH is deccreased & free T4 is increased
        TSH is deccreased & free T4 is increased
        History taking
        Physical examination
      - Toxic Multinodular Goiters
        Thyroditis
      - Pituitary Adenoma (TSHoma)
      - causes
        Excessive iodine intake
        Abnormal secretion of TSH
        Excessive intake of thyroid hormones
        Thyroiditis (inflammation of the thyroid gland)
  - TSH,T4 and T3 measurements
    - thyroid auto-antibody and serum thyroglobulin measurements, thyroid enzyme activities, biopsy of the thyroid, ultrasound and isotopic thyroid scanning
      - Autoantibodies : TSH receptor autoantibody, Thyroglobulin autoantibody, thyroid peroxidase autoantibody (more common in hypothyroidism)
        Antigen presenting cell presents TSH like antigen activating naïve t cells which activate B cells which produce TSH like autoantibodies
    - radioactive iodine scan
- Anatomy of the thyroid gland
  - Nerve supply
    - Supplied by superior, middle & inferior cervical sympathetic ganglia.
      - Fibers: Vasomotor & not secreto-motor
  - lymphatics
    - Upper part of the gland to upper deep cervical nodes via the prelaryngeal, pretracheal & paratracheal nodes.
    - Lower part to lower deep cervical nodes. The lymphatic's form a plexus & lymph can drain in any direction.