Multinodular Goitre Treatment

Question 1

what investigations should be done for a multinodular goitre

Answer 1

assess function with TSH and structure with CT scan

sometimes found incidentally on CXR

Question 2

what symptoms may be caused by invasion/compression by multinodular goitre

Answer 2

stridor, choking while lying flat

Question 3

what TSH levels are usually seen with multinodular goitre

Answer 3

usually normal or slightly suppressed, occasionally need ATDs or radioiodine

Question 4

what should be looked for on CT scan of multinodular goitre

Answer 4

retrosternal extension, tracheal compression

Question 5

what treatment options are there for multinodular goitre

Answer 5

most leave them alone as not causing problem, radioiodine if significant hyperthyroidism, surgery

Question 6

in what patients would surgical treatment of multinodular goitre be considered

Answer 6

is structural problem or significant retrosternal extension, lifestyle affecting symptoms, possibility of cancer, significant tracheal compression

Question 7

how can multinodular goitre affect flow volume loops

Answer 7

extrathoracic compression on lungs by multinodular goitre reduces inspiratory flow
(can cause orthopnoea)