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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

Functional
autonomy of

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

Venous outflow
obstruction of
the head and
neck

Facial
plethora
Engorgement
of neck

Pressure on
esophagus

Dysphagia

Pressure on
trachea

Dyspnea
Coughing
Wheezing

Pressure on
recurrent
laryngeal
nerve

Treatment:
Thyroidectomy
Radioactive
Iodine
therapy
Levothyroxine Therapy

Hoarseness

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