Goitre (thyroid mass)

Question 1

Name the two types of goitres that can be found

Answer 1

Smooth - an enlargement of the thyroid without distincy nodules
Nodular - presence of one or more distinct nodule within the thyroid gland

Question 2

Causes of smooth goitre - 4

Answer 2

• Graves disease
• Hashimotos
• Drugs
• Iodine deficiency/excess

Question 3

Causes of nodular goitre - 4

Answer 3

• Toxic solitary adenoma (a single, functional thyroid nodule so causes hyperthyroidism)
• Non-functional thryoid adenoma (benign)
• thyroid cyst
• Thyroid cancer

Question 4

Presentation of goitres - 4

Answer 4

• visible or palpable swelling in the neck
• swelling will move up on swallowing but not on tongue protrusion
• hoarseness
• Symptoms of hypo/hyper thyroidism

Question 5

Differentials of goitres - 3

Answer 5

Thyroglossal cyst - moves on tongue protrusion
Branchial cleft cyst - does not move on swallowing
Thyroid lymphoma

Question 6

Investigations of a goitre - 3

Answer 6

TFTs
Ultrasound
Fine-needle aspiration biopsy

Question 7

Management of a goitre - 5

Answer 7

Observation
Antithyroid drugs for hyperthyroidism
Levothyroxine for hypo
Radioiodine treatment
Surgery