This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
The most common presentation of endemic goiter is ? 
Select and explain. 
A. Hypothyroid, B. Diffuse goiter, C. Hypehyroid, D. Solitary nodule
B: Diffuse goiter
Answer: B: Diffuse goiter 
Explanation: Ans is 'b' i.e., Diffuse Goiter 'Endemic goiter' occurs in geographical areas where the soil, water and food supply contains only low levels of iodine. The lack of the iodine leads to decreased synthesis of thyroid hormones and a compensatory increase in TSH, which in turn leads to follicular cell hyperophy and hyperplasia and goitrous enlargement - Diffuse hyperplastic goiter. Mostly patients are euthyroid.