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the main priority is to exclude malignancy. 1-TSH 2-thyroid scan:hot vs cold 3-ultra sound:cystic vs solid 4-fine needle aspiration as a general role: if TSH is low or undetectable proceed for thyroid scan if TSH is normal, USS and FNA
treatment: if hyperthyroid (toxic multinodular): 1-surgery, only when euthyroid 2-antithyroid medications:carbimazole, propylthiouracil -/+ beta blocker dose titration block n replace high rate of relapse 3-radioidine:subsequent hypothyrodism contraindicated in pregnancy
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this patient has a multinodular goitre and he is clinicaly ? euthyroid (simple multinodular goitre)/hyperthyroid ( toxic multinodular goitre)
ReplyDeletethe main priority is to exclude malignancy.
ReplyDelete1-TSH
2-thyroid scan:hot vs cold
3-ultra sound:cystic vs solid
4-fine needle aspiration
as a general role:
if TSH is low or undetectable proceed for thyroid scan
if TSH is normal, USS and FNA
treatment:
ReplyDeleteif hyperthyroid (toxic multinodular):
1-surgery, only when euthyroid
2-antithyroid medications:carbimazole, propylthiouracil -/+ beta blocker
dose titration
block n replace
high rate of relapse
3-radioidine:subsequent hypothyrodism
contraindicated in pregnancy
if euthyroid (simple multinodualr goitre):
surgical intervention might not be needed,however it might be required for:
cosmotic reasons
press effect
possibilty of maliganacy
The new tablet would be a further extension of these concepts and yet another step into the future of computing for Apple.
ReplyDeleteThis glass would cost less than $1000 and would be available to almost all the people
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Visions Party) which is part of Neothink.
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of India. Assuming there is a God and assuming that the Bible is God's word and an historical record of His activities (and you won't
hear anything to the contrary in church and from other formal Christian religious organisations)
then the standard hype you hear, the standard image projected of God (and
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ReplyDeletethe use of internet or are incapable of visiting the State Comptrollers office and thus for them newspaper listings does the job.
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of the orchestra warming up. For documentation purposes and additional interest,
be sure to include the banner including the name of the news publication, as well
as the date section. But I felt I had something interesting, if not unique, to say about the Mafia because as a boy I had
listened not only to Mafiosi in my stepfather's kitchen but to first and second generation Sicilians who understood how and why the Mafia had gotten a foothold in this country.
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