Thyroid case anesthesia history examination management complication

thyroid related case

1. A 40 years old woman hindu by religion hailing from virar came with chief complaints of swelling over neck region with difficulty in swallowing since 3months. She is posted for total thyroidectomy .

2. History Pt first noticed small painless swelling in front of neck which increased rapidly in last 3months to current size. Associated with difficulty in swallowing, anxiety, hand tremors, heat intolerance, menstrual irregularities and weight loss. No h/o difficulty in breathing, palpitations.

3. Examination Moderately built and nourished female. Conscious, cooperative and anxious. Eyes not protruding No pallor/cyanosis/clubbing/icterus Pulse- 104/m, regular BP- 110/60 mmHg RR- 20/m

4. Importance of demographic data Age factor : ➢ Young age ✓ Deficiency goiter ✓ Dyshormonogenetic ✓ Papillary carcinoma ➢ Middle age ✓ Solitary nodular ✓ Multinodular ✓ Colloid goiter ✓ Hashimotos ✓ Follicular carcinoma ➢ Old age - Anaplastic carcinoma

5. Sex: ➢ Thyrotoxicosis - 8 times more in females ➢ Carcinoma - 3:1 ratio in females Socioeconomic status ➢ Low – Not taking treatment for Hypo/Hyper thyroidism , May present with severe symptoms And also with associated Comorbidities –Anaemia, Malabsorbtion ➢ High – Associated Illness HTN, DM, Ischemic heart disease Residence Hilly areas – More prone for Endemic goiter, Coastal areas - Hypothyroidism