Goitre Flashcards
1
Q
What is the definition of a goitre?
A
Swelling of the neck/larynx due to enlargement of the thyroid
2
Q
How common is a goitre?
A
Between 4-7% of adults have palpable thyroid lumps
3
Q
What is the pathophysiology of a goitre?
A
- Diffuse smooth goitre: entire thyroid gland is larger than normal but smooth
- Simple goitre – no clear cause, smooth and soft, associated with Graves
- Autoimmune e.g. Hashimotos – firm diffuse goitre
- Thyroiditis e.g. de Quervains
- Nodular goitre: small lump in the thyroid.
- Single/solitary nodule – e.g. cyst, benign/malignant tumour
- Multi-nodular – e.g. old age, toxic multinodular goitre
4
Q
What are the risk factors/aetiology of a goitre?
A
- Iodine deficiency: thyroid swells to compensate in making more T3/T4 - diffuse smooth goitre
- Grave’s disease - diffuse smooth goitre
- Thyroiditis caused by Hashimotos, infection or radiotherapy - diffuse smooth goitre
- Drugs e.g. lithium, amiodarone - diffuse smooth goitre
- Hereditary factors - diffuse smooth goitre
- Pregnancy/puberty/menopause - diffuse smooth goitre
5
Q
What are the signs/symptoms of a goitre?
A
- Swelling of the neck
- Mostly painless – unless thyroiditis
- Hyperthyroid/hypothyroid symptoms
- When swallowing does the lump move? – thyroid lumps and thyroglossal cysts move upwards on swallowing
- Protruding tongue – thyroglossal cyst moves up
- Bruit
- Difficulty swallowing - REDFLAG
- Stridor - REDFLAG
- Hoarseness of voice - REDFLAG
- Enlarged lymph nodes - REDFLAG
6
Q
What investigations are carried out for goitres?
A
- TFTs/Thyroid antibodies
- Thyroid US +/- biopsy or fine needle aspiration
- Thyroid x-ray
- Basal plasma calcitonin and cardinoembryonic antigen – if thyroid cancer is suspected
7
Q
What are the surgical treatments for a goitre?
A
• Partial/full thyroidectomy
8
Q
What are the pharmacological treatments for a goitre?
A
- Levothyroixine
- Radioactive iodine
- Iodine replacement
9
Q
What are the non pharmacological treatments for a goitre?
A
• No symptoms/cancer = no treatment
