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Describe the thyroglossal duct cyst pathology?

The thyroid starts off a the base of the tongue embryologically and then descends to the anterior neck through the thyroglossal duct. This duct is supposed to involute, however in this path there is a cystic dilation of the thyroglossal duct.


How does the Thyroglossal duct cyst present?

Presents as an anterior neck mass.


What path would present as a mass at the base of the tongue?

There is persistance of the thyroid tissue at the base of the tongue when all of the tissue is supposed to descend.


What are the two physiologic changes that occur in hyperthyroidism, what is hyper thyroidism and why do these changes happen?

Hyperthyroidism is an increased level of circulating thyroid hormone, which results in an increase of the basal metabolic rate (by increasing the synthesis of the Na/K ATPase) and increased sympathetic nervous system activity (increased expression of the beta 1 adrenergic receptors).


What are the clinical symptoms of hyperthyroidism?

Related to the body "going into overdrive," thus weight loss despite having an increased appetite, which will lead to muscle loss and weakness. Bone reabsorption w/ hypercalcemia (which can contribute to tremors). Heat intolerance, sweating, tachycardia with increased output which can result in arrythmias (like a-fib, particularly in the elderly). Anxiety, insomnia and hightened emotions. Staring gaze with lid lag, oligomenorrhea, and diarrhea with malabsorption.


What does hyperthyroidism do to cholesterol and blood sugar?

It will cause hypoglycemia and hyperglycemia, increased thyroid hormones will induce gluconeogen and glycogen lysis.


What is the most common cause of hyperthyroidism and who are prone to get them?

Graves disease is the most common, women of child bearing age tends to get this. Graves disease has IgG antibodies that stimulates the TSH receptor, resulting in both the increase synthesis and secretion of thyroid hormones.


What are the clinical features of Graves disease?

Hyperthyroidism induced diffuse goiters (stimulation of the TSH receptors leads to hypertrophy and hyperplasia of the thyroid gland). Exopthalmos and pre-tibial myxedema is also seen.