Need help with endocrine question

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

LoneSEAL

Senior Member
10+ Year Member
15+ Year Member
20+ Year Member
Joined
Dec 25, 2000
Messages
111
Reaction score
0
I'm studying endocrinology right now. There's a topic that I don't quite understand: goiter. It says the goiter is due to recurrent episodesof TSH stimulation (hyperplasia) and involution (colloid stage). Eventually, the gland is diffusely enlarged but eventually becomes multinodular.

I have several questions here.

1.) What is meant by "involution (colloid stage)"?
2.) What is meant by multinodular? Why does it become multinodular?
 
The most common reason for goiter formation is iodine defficiency. This will cause an increase in TSH levels, which in turn will cause hypertrophy of thyroid follicles. if the iodine supply increases or if the need for iodine decreases, the follicular epithelium"involutes" to give a colloid-rich, enlarged gland-hence the term colloid.
If this process is repeated many times, the result will be an irregular enlargement of the thyroid, the multinodular goiter. The cause for multi nodule formation is not clearly known. It may be due to differences in the ability o individual follicular cells to respond to TSH stimulation. I was thinking that the thyroid consists of follicles, some of which will simply grow more than others, in order to keep this in my memory.
Now, can someone please tell me what he would do if 9 weeks afer taking step 1 he hadn't received his score report? I m sending them mail after mail complaining, but they just respond with"premade" mails, reassuring that everything is ok. And their f******g phone line never seems to be free!!
 
correct me if i am wrong, but i thought the multinodularity was due tro the fact that some of the areas (the hyperplastic ones) became somewhat independent of stimulation and thus stayed big in the absence of tsh while the other areas (the atrophic areas interventing between the hyperplastic nodularities get small because a "hot " nodule makes t4 and causes a big drop in tsh so that the normally responsive areas get very atrophic.
 
No need to correct anything. This is just how I found it in Robbins.
 
Thanks for the answers -- it makes more sense to me now. Theodore, I suggest the next time you get on the phone with the NBME, ask to speak the supervisor. Get his/her name and document the situation. If the situation is not resolved, I would send a certified letter to the organization...good luck.


I've got a second question. If a man has dysuria and a milky discharge, but there are no neutrophils or bacteria, does this man have prostatitis?
 
i think that is the presentation of chronic prostatisis- wouldn't they give you some enzymes- like alk phos or something too though?
 
Nope -- no other info was there...of course, this question was from about a month ago from the paper-pencil NBME shelf exam so my memory might not be exactly correct...

I'd think the answer would be prostatitis except that Robbins says in prostatitis you need to have at least 10 leukocytes...is a leukocyte the same thing as a neutrophil?
 
Yeap, that's it. Leuko(from greek white) and cyte(from greek cytos=cell). Hehe, that's one of the few good things about being a Greek nowadays😀
Loneseal, I called their office in Netherlands and they forwarded me to their US headquarters( the one in Philadelphia). Only problem is that the answering machine comes on,gives a half an hour long list of options to choose from(and mine was the 7th), and then a loooooooooooong waiting. Plus the only time I can call them from here is around 2-3pm eastern time, and the line is just so busy then. Last time I gave up waiting after 45 minutes (and more than 50 bucks in the Hungarian telephone company). I sent them an e-mail last week and they haven't responded yet. Funny thing is, I can't say"well you know, i tried to apply again for step 1 and your system cut me off saying that i've passed, and i'm just curious about my score", but rather write in a poietic, anxious mood that"i"ll be done with 5th year in a couple of weeks, and knowing the outcome of my test is essential in making up my schedule". Seriously though,i'm getting disturbed with this delay. I mean, I paid around 600$ for the exam fee, another 500$ for the books, not to mention an 18 month struggling, trying to combine my exam periods with studying for step 1. I even offered to pay them the fee for sending it with courrier (maybe they were insulted, and that's why they're delaying it so much)!!
 
Top