This document discusses thyroid disorders and their presentation at different ages. It outlines the typical symptoms and signs seen with various thyroid pathologies like physiological goiter, multinodular goiter, hyperthyroidism, hypothyroidism, and thyroid cancers. The document provides guidance on evaluating a patient with a thyroid swelling, including taking a history and examining for features suggestive of specific disorders. It also discusses possible differential diagnoses and management options.

1. By
Dr / Ahmed Osama Hassan
Assistant lecturer of pediatric surgery

3.  Name
 Age
 Sex
 Occupation
 Residence
 Marital state
 Special habits

4.  20 years >>> papillary carcinoma
physiological goitre
 30 years >>> MNG , 1RY thyrotoxicosis
 40 years >>> 2ry thyrotoxicosis ,
follicular carcinoma
 50 years >>> anaplastic carcinoma

5.  female patient named …….& married since
….. And has …. Children , the youngest is …..
Years old . The patient is work

6.  Swelling in the neck + pain
 Toxic syptoms
 Pressure or neoplastic

7.  Swelling
 In the front of the neck + lateral swelling !!!!

8.  Slowly progressive
1. toxic and nodular goitre
2. papillary carcinoma
 Rapid progressive
Anaplastic carcinoma ( rapid onset )
 Regressive : subacute thyroiditis

9.  In the gland
 Hge
 Inflammation
 Malignancy

10.  Outside gland
 Bone ache
 Pain referred to ear

11. CVS
 Palpitation
 Exertional dyspnea

12.  CNS
 Insomnia
 Irritability
 Nervousness
 Nightmares

13. GIT
 Loss of weight
 Intolerance to hot tempreture

14.  Rapid increase in size
 Hoarseness of voice
 Pain in the gland
 Pain referred to ear

15.  The condition started …. By swelling at lower
part of the neck with gradual onset and slowly
progressive course . The swelling moves up
and down with deglutition . Swelling not
painful
 There is no symptoms suggest thyrotoxicosis
 There is no symptoms suggest malignancy
 There is no pressure symptoms

16.  Similar condition
 Other disease ( DM , HPN )
 Operation
 Medication
 Drugs or irradiation

17.  Medullar carcinoma
 Pendred syndrome
 Exposure to same condition
 Enzymatic deficiency

18. Thanks