Multinodular Goitre Flashcards

1
Q

what do you do if you find one?

A

assess function

assess structure - what is being squashed - symptoms of stridor or choking when lying flat

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2
Q

what are the investigation findings?

A

TSH - usually normal or slightly suppressed may need anti-thyroid drugs
CT scan - retrosternal extension or tracheal compression

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3
Q

how is it managed?

A

most can leave alone
RAI (radioactive iodine) if significant hyperthyroid
surgery if structural problem (or significant retrosternal extension)

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4
Q

when to offer surgery for retrosternal goitres?

A

Lifestyle interfering symptoms
Possibility of cancer
Significant tracheal compression (?<7 mm) if symptomatic
Tracheal Flow Loops if other respiratory potential causes of orthopnoea/breathing difficulties
? Audible Stridor

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