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BOF: 35

A sixty-year-old female presents with a history of palpitations and swelling in the neck.

On examination of the pulse there is atrial fibrillation and in the neck there is a large multinodular goitre.

In this patient which one of the following are likely

a)      Eye signs are common

b)      Eye signs are rare

c)      Spontaneous remission is likely

d)      Long term antithyroid drugs are effective in controlling symptoms

e)      Thyroxine will help to reduce the size of the goitre

Answer:

b)

This patient has toxic multinodular goitre. In this condition eye signs are rare unlike Grave’s disease. Spontaneous remission is rare. Antithyroid drugs will increase the size of the goitre and are only used as a temporary measure prior to definitive treatment. Thyroxine will not reduce the size of the goitre.

Thyrotoxicosis

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