 Welcome back to our MedSmarter question of the week where we're taking a smarter approach to preparing future physicians. Before we get started, if you'll take just a quick minute and click that like button and also subscribe and turn the bell on so that you'll be notified when we post new videos. Let's get right to that question. And as always, we start with the last sentence of the vignette and then go back and read the rest. Hypersecretion of this hormone can cause which of the following conditions. So this tells me I'm looking for something that has to do with hormone-causing conditions that we'll see in our answer choices. A four-year-old girl is brought to the pediatrician by her mother because she has noticed a single, soft, non-tender mass underneath her daughter's tongue. The physician reassures the mother that it is a common congenital ectopic anomaly that does not affect the function of the mass or the hormone it secretes. Hypersecretion of this hormone can cause which of the following conditions. So we're dealing here with a single, soft, non-tender mass under the tongue. So we're trying to see what hormone is secreted by that single mass and what would that cause. So take a minute, look at these answer choices, read back over the question, come up with an answer and write it in the comment box below. So what I believe we're looking at here is a thyroglossal duct cyst. And the thyroglossal duct is a remnant of the pathway that the thyroid takes when it develops at the base of the tongue as it travels down to the neck where it is in its final resting position. So sometimes you can have some thyroid tissue remaining in that duct and that's where we have that ectopic duct cyst that can occur. So that thyroid gland would be secreting thyroid hormone. So we're looking at something that is a sequela of hyperthyroidism from extra thyroid hormone production. So let's look at these answer choices, cold intolerance. I know cold intolerance is a symptom of hypothyroidism, which is going to be low thyroid. So that's not going to be something that I'm going to think of in a thyroglossal duct cyst situation. B constipation. Constipation is also a hypothyroidism symptom. So in this case we're looking at high thyroid hormone levels not going to be associated with constipation. C amenorrhea. Amenorrhea can be something associated with hyperthyroidism. Hyperthyroid can mess up the menstrual cycles from that hypersecretion of the T4. So we'll leave that one in here. Let's look at the rest of them though. Hyperlipidemia. I know that is also a hypothyroid or a low thyroid cause. So we will take that out. And then weight gain. Obviously one of the most common things associated with hypothyroidism is weight gain. So the low thyroid hormone, decreased metabolism and weight gain. So that leaves me with C. Amenorrhea is my only option for an answer. And C is the correct answer. So like we said this is a thyroglossal duct cyst. And that is in that pathway between the tongue to the thyroid as it descends during development. It resides eventually in the anterior portion of the trachea in the neck. But that ectopic thyroid tissue can be found anywhere along that duct. And specifically beneath the tongue where its origin is. So this is a pretty common anomaly. It does not affect the function of the mass and the hormone it secretes. Typically it doesn't affect thyroid function so we're not going to remove it. But in this situation as it's asking what is the kind of original origin of that thyroglossal duct. What could it be associated with? You've got to be able to parse those together. So thyroid hormone, if there's a potential elevation of the thyroid hormone out there. Then Amenorrhea is going to be our only option choice here that was given to us. If you found this material helpful for your studying please like and consider subscribing to the channel. Also share this video so that more people can benefit from it like you have.