MedBugs: SAQ #178

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Case: Post-thyroidectomy airway compromise

A previously well, 37-year-old female presents to your rural ED with a history of acute shortness of breath. She underwent an elective total thyroidectomy in an urban centre 3 days ago and was discharged from hospital today. The patient has no other significant comorbidities. Her current medications include 100mcg of levothyroxine (once daily) and she reports no allergies. Her initial observations at triage are documented as “stable”.

1. Other than hypocalcaemia, list four important post-operative complications of thyroidectomy. 4 marks

2. List three clinical features associated with hypocalcaemia. 3 marks

The patient has no clinical features to suggest hypocalcaemia. On examination the patient is noted to have an expanding swelling affecting the anterior neck, covered by a simple dressing, as well as audible stridor. They are immediately moved to a resus bed and monitoring atached.

3. Outline five immediate management steps for an expanding neck haematoma with stridor. 5 marks

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Case: Post-thyroidectomy airway compromise

1. Other than hypocalcaemia, list four important post-operative complications of thyroidectomy. 4 marks

2. List three clinical features associated with hypocalcaemia. 3 marks

3. Outline five immediate management steps for an expanding neck haematoma with stridor. 5 marks

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