Thyroid nodules

Question 1

Define Thyroid nodules

Answer 1

Toxic Thyroid adenoma is often a single active nodule that causes hyperthyroidism
almost always benign
can be subclinical hyperthyroidism-with suppressed TSH but normal t3/4

Question 2

Aetiology and risk factors of Thyroid nodules

Answer 2

Usually from gain of function mutations in thyroid cells-idenpendent of TSH

Risk factors:
Iodine deficiency is most common cause
Young adult age
FHX
Female
Head and neck irradiation

Question 3

Epidiemology of thyroid nodule

Answer 3

about 3.3 cases in 100 000 per year

account for about 5% of hyperthyroidism (which affects about 2% of UK adults)

Question 4

Signs and sx of thyroid nodules

Answer 4

Palpable nodules

then classical hyperthyrodism
Increased appetite, weight loss
Heat intolerance, nervousness, palpitations, tachycardia, high blood pressure, tremor
diarrhoea
Dyspnea
Hoarseness, mood change

NO exophthalmos or non pitting leg oedema

Question 5

Investigations of thyroid nodules

Answer 5

TSH-should be suppressed
T3/t4-can be normal, most often high

Thyroid ultrasound–can see one or more nodule

Iodine 23 uptake scan-can see the hot nodule-hyperactive

TSHR and TPO AB (graves marker) negative