USMLE/COMLEX - Step 2 - Goiter

USMLE/COMLEX - Step 2 - Goiter Goiter is an enlarged thyroid gland whose pathophysiology depends on the underlying cause. For example, iodine deficiency causes diffuse enlargement as the thyroid tries to increase iodine uptake. Autoimmune diseases like Hashimoto's and Graves' cause inflammation and enlargement. Nodular goiter is characterized by one or more nodules, which can be benign or malignant, and its cause is not fully understood but may involve genetics or radiation exposure. Swelling or enlargement of the neck Tightness or pressure in the neck Difficulty swallowing or breathing Hoarseness or changes in voice Coughing or wheezing Enlarged thyroid gland Nodules Swelling or prominence of veins in the neck Difficulty swallowing or breathing Hoarseness or changes in voice Symptoms of hyperthyroidism or hypothyroidism Physical exam Blood tests Ultrasound Fine needle aspiration biopsy Radioactive iodine uptake test Thyroid scan CT scan or MRI The treatment for goiter depends on the underlying cause and the severity of the symptoms. Some common treatments include: 1. Iodine supplements: If the goiter is caused by iodine deficiency, iodine supplements may be prescribed to help reduce the size of the goiter and improve thyroid function. 2. Medications: If the goiter is caused by an autoimmune disorder such as Graves' disease or Hashimoto's thyroiditis, medications may be prescribed to regulate thyroid hormone levels and manage symptoms. 3. Radioactive iodine therapy: Radioactive iodine can be used to shrink the thyroid gland and reduce the size of the goiter. This treatment is often used for hyperthyroidism. 4. Surgery: If the goiter is very large, causes difficulty breathing or swallowing, or is suspected to be cancerous, surgery may be necessary to remove part or all of the thyroid gland.