1. Adult Medical-Surgical Nursing Endocrine Module: Goitre

2. Goitre  A goitre is an enlargement of the thyroid gland

3. Goitre: Classification and Aetiology  Toxic goitre (hypersecretion): Grave’s disease, hyperthyroidism (auto-immune: thyroid-stimulating antibodies like TSH → hyperplasia and ↑ secretion)  Non-toxic (hyposecretion):  Hashimotos disease: hypertrophy related to growth-stimulating antibodies but hyposecretion (auto-immune thyroiditis)  Increased TSH in response to hyposecretion of thyroid → enlarged gland  Iodine deficiency (compensatory growth)

4. Goitre: Diagnosis  Hormonal assays: TSH, T3, T4, FT4  Measure presence of thyroid antibodies  Scan to measure uptake of radioactive iodine: I 131  Needle biopsy to rule out malignancy and auto-immune destruction of tissue

5. Goitre: Management  If related to hyposecretion, treat with thyroxine to prevent further enlargement  If related to iodine deficiency, treat cause  If related to hyperthyroidism, treat the condition (anti-thyroid drugs, radiation therapy or surgery)  If increased pressure symptoms, surgery may be necessary