2Grave’s disease although it is necessary in the assessment of toxic solitary andmultinodular goiter to determine the site of nodular overactivity.- radioactive iodine uptake studies are particularly appropriate revealing anincreased uptake.- chest X ray- position of trachea- laryngoscopy- mobility of the vocal cords preoperatively- ecg- cardiac activity.
In Graves’s disease three treatment modalities can be used either alone or incombination to restore the euthyroid state:- antithyroid drugs- radioactive iodine- surgery
These drugs interfere with the thyroid hormones synthesis.Medical treatment with antithyroid drugs has two principal roles:- treatment of newly diagnosed patients with Grave’s disease in the hopeof inducing a permanent remission- render the toxic patient euthyroid in preparation for surgery.
Many of the manifestations of hyperthyroidism, particularly those relating to thecardiovascular system, can be ameliorated by the administration of beta- blockers such as metoprolol.Beta-blockers are usually used in combination with one of antithyroid drugs in patients who are severely toxic and in those patients being prepared for surgery.
used to control thyrotoxicosis achieves its effect by destruction of overactive thyroid tissue.There would appear to be no adverse effects of I
treatment with respect toleukemia, thyroid carcinoma, fetal damage or genetic mutation.An ablative dose will render more than 60% of patients hypothyroid in one year.Regular long-term surveillance is required and thyroxine replacement given asnecessary.
Thyroidectomy in patients with Graves’s disease is safe and rapidly renders the patient euthyroid. The principal indications for surgery are:- relapse after an adequate course of antithyroid drugs- severe thyrotoxicosis with a large goiter