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Pathophysiology of Non-toxic Nodular Goiter Precipitating Factors: Diet History of Radiation Regular intake of substances (Goitrogens)
Predisposing Factors: Age Gender Genetics Geographic
Decreased/Suppression of synthesis of thyroid hormones
Decreased T4 and T3 in the body
Negative feedback: Increased production of TSH
Heterogeneous growth of thyroid follicles
Ischemic necrosis of expanding follicles
Development of nodules
Thyroid architecture loses uniformity
Gradual enlargement of the Thyroid Gland (Nontoxic Nodular Goiter)
Functional autonomy of thyroid follicles
TSH receptor gene mutation
Toxic Multinodular Goiter
May lead to Thyrotoxicosis
Thyroid Storm
Heart Failure
Death
Visible and palpable mass (Goiter)
Pressure on anterior neck structures
Venous outflow obstruction of the head and neck
Facial plethora Engorgement of neck veins
Pressure on esophagus
Dysphagia
Pressure on trachea
Dyspnea Coughing Wheezing
Pressure on recurrent laryngeal nerve
Treatment: Thyroidectomy Radioactive Iodine therapy Levothyroxine Therapy
Hoarseness