multi nodular goitre

Question 1

what is a multinodualr goitre

Answer 1

benign thyroid nodules

Question 2

multi nodular goitre are more common in

Answer 2

areas where there is iodine deficiency, this is though to lead to reduced efficiency of thyroid hormone formation which causes subtle increases in TSH, over the this causes hyperplasia, increased cell turnover and somatic mutagenesis which can lead to the formation of a multi nodular goitre

Question 3

TSH levels

Answer 3

are initially normal bit over time they usually became surpassed as the goitre has autonomous function and secreted thyroid hormones causes hyperthyroidism

Question 4

if the multi-nodular goitre is causing hyperthyroidism whats it called

Answer 4

toxic multi nodular goitre

Question 5

what the issue with large multi-nodular goitres

Answer 5

• tracheal compression

- retrosternal extension

Question 6

what is required to check if other structures are involved

Answer 6

CT scan

Question 7

diagnosis is confirmed with a

Answer 7

radioisotope uptake scan which should show increased uptake

Question 8

if the radioisotope scan is negative

Answer 8

this suggests it it is a malignant cancer and needs further investigation using an ultrasound guided fine needle aspirate

Question 9

management if small

Answer 9

no intervention required but annual thyroid function tests should be carried out to ensure it has not become a toxic multi-nodular goitre

Question 10

if a toxic multi-nodular goitre is caused hyperthyroidism

Answer 10

radioactive iodine ablation

Question 11

if a multi-nodular goitre is compressing structures or significantly extending

Answer 11

thyroidectomy