Concept
Thyroid conditions
The degree of escalation of management for thyroid lumps presenting in primary care depends on the clinical presentation and presence or absence of concerning features.
- Immediate hospital admission for patients with symptoms & signs of airway compromise, such as severe stridor
- Urgent referral (2-week rule) to a thyroid surgeon or endocrinologist for the following patient groups:
- Unexplained hoarseness or voice changes associated with a goitre
- Lymphadenopathy associated with a thyroid lump (usually deep cervical or supraclavicular region)
- Rapidly enlarging painless thyroid mass increasing in size over a period of weeks
- Child with thyroid nodule
- Non-urgent referral for the following patient groups:
- Patients with thyroid nodules with abnormal thyroid function tests (TFTs)
- Sudden-onset pain in a thyroid lump (bleeding into a benign thyroid cyst)
- Newly presenting thyroid lump with no concerning features
- Manage in primary care for patients with a thyroid nodule or goitre that has not changed for several years and without any of the following concerning features:
- Adult patient with history of neck irradiation
- Family history of thyroid cancer
- Palpable cervical lymphadenopathy
- Stridor or voice changes
Correct Answer:
B
ASCENT 