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.
Revision Tip
Revise thyrotoxicosis KEYS to
SUCCESS in Medicine page 24-26
