Euthyroid goiter, nodular goiter, iodine deficiency
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This topic is about thyroid enlargement with normal thyroid function and the evaluation of thyroid nodules. The key exam logic is:
Goiter = enlarged thyroid. Euthyroid goiter = enlarged thyroid with normal thyroid hormone function. Nodular goiter = one or more thyroid nodules inside an enlarged thyroid. Iodine deficiency = classic cause of diffuse goiter and later multinodular goiter.
The most important clinical questions are:
- Is thyroid function normal, hyperthyroid, or hypothyroid?
- Is there compression of the trachea/esophagus?
- Is any nodule suspicious for malignancy?
- Is the goiter caused by iodine deficiency, autoimmune disease, autonomy, or tumor?
Modern nodule workup is based on serum thyroid-stimulating hormone (TSH) and thyroid ultrasound risk stratification, with fine-needle aspiration (FNA) guided by ultrasound pattern and size. ([PMC][1])
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