Goitre

Question 1

Goitre: ? enlargement of the thyroid gland. There are certain characteristics
to describe;
? vs.?: pattern of swelling.
? vs.?: is it actively secreting thyroid hormone.
? vs.?.

Answer 1

painless
diffuse
nodular
simple
toxic
benign
malignant

Question 2

Diffuse goitre ddx;

Physiological.
?, ?(increased iodine requirements).

Autoimmune.
? disease, ? disease.

Thyroiditis.
Sub-acute (? ?) thyroiditis, Riedel’s thyroiditis.

Endemic.
? deficiency.

Drugs.
Anti-? drugs, ?, ? excess, ?.

Answer 2

puberty
pregnancy
hashimoto's
grave's
de quervain's
iodine
thyroid
amiodarone
iodine
lithium

Question 3

Nodular goitre ddx;

Multinodular.
? multinodular goitre, ? thyroiditis.

Solitary nodule.
? adenoma, ? nodule, thyroid ?, ?,
metastasis.
One prominent nodule from a ? goitre.

Infiltration (rare).
??, ?.

Answer 3

toxic
subacute
follicular
benign
malignancy
lymphoma
multinodular
TB
sarcoid

Question 4

With time, the goitre may extend to produce ? symptoms on the ?, ? or ?. Extension may be mainly ?.

Answer 4

pressure
trachea
oesophagus
veins
retrosternal

Question 5

Investigations for a thyroid swelling;

FBC: Assess for related ?.
?: May indicate thyroiditis / autoimmune disease.
TFTs: ? + ?
Thyroid ?: autoimmune disease.

Answer 5

anaemia
esr
tsh + free t4
autoantibodies

Question 6

Investigations for a thyroid swelling

CT ? and ? : if ? symptoms.
?: to distinguish between solid and ?masses.
o Not required in all cases.
?: if clinical concern regarding
malignancy.

Answer 6

neck
thorax
pressure
uss
cystic
fnac

Question 7

Management;
Generally depends on whether the patient is ?-thyroid, or ?-thyroid.
In a ?-thyroid patient, treatment is not required for a non-? nodule unless it is causing ? symptoms.

Answer 7

hypo
hyper
eu
malignant
pressure