Thyroid cancers can affect the follicular or parafollicular cells of the thyroid gland. The most common types are papillary carcinoma, follicular carcinoma, and medullary carcinoma. Risk factors include genetics, family history, radiation exposure, and iodine deficiency. Symptoms may include thyroid nodules, neck lymphadenopathy, or changes in voice. Diagnosis involves blood tests, ultrasound, biopsy, and imaging. Treatment depends on cancer type and severity but commonly includes surgery followed by radiation or other therapies. Prognosis depends on factors like cancer stage, size, and spread.
The most common thyroid problems involve abnormal production of thyroid hormones. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism. Fewer than 1% of all thyroid nodules are malignant (cancerous). Females are more likely to have thyroid cancer at a ratio of 3:1. The cause of thyroid cancer is unknown, but certain risk factors have been identified and include a family history of goiter, exposure to high levels of radiation, and certain hereditary syndromes
The most common thyroid problems involve abnormal production of thyroid hormones. Too much thyroid hormone results in a condition known as hyperthyroidism. Insufficient hormone production leads to hypothyroidism. Fewer than 1% of all thyroid nodules are malignant (cancerous). Females are more likely to have thyroid cancer at a ratio of 3:1. The cause of thyroid cancer is unknown, but certain risk factors have been identified and include a family history of goiter, exposure to high levels of radiation, and certain hereditary syndromes
The thyroid is a gland at
the front of your neck beneath your voice box (larynx).
A healthy thyroid is a little larger than a quarter. It usually can’t be felt
through the skin.
The thyroid has two parts (lobes). A thin
piece of tissue (the isthmus)
connects the two lobes.
The thyroid makes hormones:
-- Thyroid hormone: The thyroid
follicular cells make thyroid
hormone. This hormone affects heart rate, blood pressure, body temperature,
and weight. For example, too much thyroid hormone makes your heart race, and
too little makes you feel very tired.
-- Calcitonin: The C
cells in the thyroid make calcitonin.
This hormone plays a small role in keeping a healthy level of calcium in
the body.
Four or more tiny parathyroid
glands are on the back of the thyroid. These glands make parathyroid
hormone. This hormone plays a big role in helping the body maintain a
healthy level of calcium.
http://www.cancer.gov/cancertopics/wyntk/thyroid
A supercool powerpoint about thyroid cancer that is very hard to understand unless I am speaking to you and filling in the blanks so check out my blog and look for a related post:
http://m4tt5-b10-bl0g-2o1o.blogspot.com/
The thyroid is a gland at
the front of your neck beneath your voice box (larynx).
A healthy thyroid is a little larger than a quarter. It usually can’t be felt
through the skin.
The thyroid has two parts (lobes). A thin
piece of tissue (the isthmus)
connects the two lobes.
The thyroid makes hormones:
-- Thyroid hormone: The thyroid
follicular cells make thyroid
hormone. This hormone affects heart rate, blood pressure, body temperature,
and weight. For example, too much thyroid hormone makes your heart race, and
too little makes you feel very tired.
-- Calcitonin: The C
cells in the thyroid make calcitonin.
This hormone plays a small role in keeping a healthy level of calcium in
the body.
Four or more tiny parathyroid
glands are on the back of the thyroid. These glands make parathyroid
hormone. This hormone plays a big role in helping the body maintain a
healthy level of calcium.
http://www.cancer.gov/cancertopics/wyntk/thyroid
A supercool powerpoint about thyroid cancer that is very hard to understand unless I am speaking to you and filling in the blanks so check out my blog and look for a related post:
http://m4tt5-b10-bl0g-2o1o.blogspot.com/
VAC therapy also known as negative pressure wound therapy (NPWT) is a method of delayed wound closure, where in primary closure is not possible. this PPT details the make & model of the device, its modifications, principle , mechanism , advantages and disadvantages
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
3. Epidemiology
• Commonest endocrine malignancy
• 1% of all malignancies
• 0.6 per million
• Good prognosis
• Extent of surgery is debated
• Annual Incidence is 3.7 per 100,000
• Sex Ratio is 3:1 (Female:Male)
• Can occur in any age group
4. Causes and Risk Factors
• Genetics:
• Abnormal RET oncogene may cause MTC.
• MEN 2A, 2B Syndrome.
• Family History:
• Hx of goiters increase risk for Follicular Ca.
• Radiation Exposure:
• Radiation therapy to Head / Neck (<15 y).
• Exposure to Radioactive Iodine during childhood, or other radioactive
substances (Chernobyl) ↑ risk - Papillary carcinoma.
5. Causes and Risk Factors
• Chronic Iodine deficiency ↑ risk for Follicular carcinoma.
• Gender:
• Female > Males.
7. Presentation
• Solitary or Multiple thyroid nodules
• Neck Nodes
• Hoarse voice of recent onset
• Mediastinal adenopathy
• Bone or lung metastasis
8. Important History
• Radiation to neck / chest
• MEN syndrome
• Family history
• Diarrhoea
• Adrenal tumour
• Recent change in a pre-existing goitre
• Size change/nodularity
• Vocal cord palsy
11. Laboratory
• Most patients are Euthyroid.
• Hyperfunctioning nodule 1% chance of malignancy.
• Serum Tg cannot differentiate between benign and
Malignant nodules
• Tg is used for:
• F/U after total thyroidectomy
• Serial F/U for non-operative treatment
• Serum Calcitonin patients with MTC, or with family hx of
MTC (MEN2)
12. FNA Cytology
• Single most important test.
• U/S guidance improve the sensitivity.
• Accuracy ranges from 70 – 95%.
• Nodules
• FNAC cannot differentiate between Benign and
Malignant Follicular Neoplasia
13.
14.
15. Imaging
• U/S is the investigation of choice.
• C.T Regional and distant metastases
• MRI Limited role in the diagnosis
Useful in detecting cervical LN
metastases
• Scintigraphy (I-123)
• Characterizing funtioning nodules
• Staging of follicular and papillary Ca
16. US features malignancy
• Hypoechoic
• Tall>wide
• Irregular margins
• Microcalcifications
• LN involvement
• Extrathyroidal spread
17. Prognosis
Tumor Prognosis
Papillary Ca.
74-93% long-term survival
rate
Follicular Ca.
43-94% long-term survival
rate
Hurthle Cell Ca.
20% mortality rate at 10
years
Medullary Ca.
80% 10-year survival rate
45% with LN involvement
Anaplastic Tumor
Median survival of 4 to 5
months at time of diagnosis
18. Papillary Carcinoma
MC Thyroid ca (80%)
Related to radiation exposure in I-sufficient areas.
F:M - 2:1
Mean age 30 - 40 y
Slow growing painless mass. Euthyroid-status.
LN metastases is common, may be the presenting symptom
(LAT?).
Distant metastases is uncommon at initial presentation.
Develop in 20% of cases. (Lungs, liver, bones,brain)
19. Papillary Carcinoma
• FNA biopsy is diagnostic.
• Treatment
• Ipsilateral Lobectomy + Isthmusectomy (No LN metastasis)
• Near-total or Total Thyroidectomy + Modified-radical or Functional neck
dissection (+ve LN metastasis).
• Prophylactic LN dissection is unnecessary.
20. Follicular Carcinoma
• 10% of all thyroid cancers.
• More common in I-deficient areas.
• F:M - 3:1
• Mean age- 50 yrs.
• Solitary thyroid nodule, rapid increase in size and long-
standing goiter.
• Cervical LN metastasis is uncommon at presentation (5%),
distant metastasis may be present.
• Hyperfunctioning < 1%. (S&S of Thyrotoxicosis)
21. Follicular Carcinoma
• FNA biopsy cannot differentiate between benign and
malignant follicular tumors.
• Pre-operative diagnosis of malignancy is difficult unless there is distant
metastasis.
• Large follicular tumor > 4 cm in old individual CA.
• Treatment:
• Thyroid Lobectomy (at least 80% are benign adenomas)
• Total-Thyroidectomy in older individual with tumor > 4cm (50% chance of
malignancy).
• Prophylactic nodal dissection is unnecessary.
22. Post-operative Management
• Thyroid hormone
• Replacement therapy
• Suppression of TSH release
• At 0.1 μU/L in Low-risk group
• < 0.1 μU/L in High-risk group
• Thyroglobulin measurement
• At 6-months interval then annually when disease-free
• < 2ng/mL in total or near-total + Hormones
• < 5ng/mL in hypothyroid patients.
• Level > 2ng/mL = Recurrence/Persistent thyroid tissue
23. Post-operative Management
• Radioiodine Therapy:
• ETE , LN + , Aggressive histo (Tall, Columnar)
• RAI is less sensitive than Tg in detecting metastatic disease.
• I-131 detect and treat 75% of metastatic differentiated thyroid
tumors.
24. Medullary Carcinoma
• 5% of all thyroid malignancies.
• Arise from Parafollicular cells, concentrated in
superolateral aspect of thyroid lobes.
• Most cases are sporadic, 25% are inherited
(Germline mutation in RET oncogene).
• F:M - 1.5:1
• Age b/w 50 - 60 yrs.
• Neck mass + palpable cervical LN (15-20%).
• Local pain or aching is common.
25. Medullary Carcinoma
• MTC secretes a range of compounds:
• Calcitonin, CEA, CGRP, PG A2 and F2α, Seritonin.
• May develop flushing and diarrhoea, Cushing’s
syndome (ectopic ACTH).
• Diagnosis
• Hx and P/E (Family hx of similar tumors).
• ↑ Serum Calcitonin, ↑ CEA
• FNAC
• Screen patient for:
• RET point mutation.
• Coexisting Pheochromocytoma (24-hour urinary level
of VMA, catecholamine, metanephrine).
• Hyperparathyroidism (Serum calcium).
26. Medullary Carcinoma
• Treatment:
• > 50% are bilateral, ↑ Multicentricity.
• Total Thyroidectomy + :
• Bilateral central node dissection as routine (No LN
involvement)
• Bilateral Modified-Radical Neck dissection (palpable LN)
• Ipsilateral Prophylactic nodal dissection in tumor size > 1.5cm.
• External Beam radiation for unresectable residual or
recurrent tumor.
27. Anaplastic Carcinoma
• 1% of all thyroid malignancies.
• Women > Men.
• Majority present at 7th - 8th decade of life.
• Rapidly enlarging in size.
• May be painful, with dyphonia, dyspnea, dysphagia.
• LN are usually involved at presentation.
• ± Distant metastasis.
28. Anaplastic Carcinoma
• FNAC is diagnostic.
• Treatment:
• Most aggressive thyroid tumor.
• Total Thyroidectomy if resectable.
• Adjuvant Chemotherapy + Radiotherapy slightly improve long-term
survival.
