A lady patient of 58 years c/o e pisodes of tachycardia, i ntolerance to cold, weight loss of 4 kg, pain over left shoulder area, neck, left arm, chest pain more on left lateral chest since 15 days. Before this, she was absolutely normal doing the morning walk all household work. On examination BP 150/90, bilateral thyroid lobe enlarged and scar mark of thyroidectomy, free T 4 -1.02, free T 3 -3.39, TSH 1.09. S. Calcium 9.7 mg.
Vit 29.7 CBC TLC 9500 Cummings L49 P40. Xray chest shows cardiomegaly and superior mediastinum wide. USG thyroid shows heterogeneous tissue, bil enlarge lobes with small and big nodules in both lobes, 2D-echo of heart ef 61%. Patient has H/o thyroidectomy 30 years back. What could be the diagnosis and treatment of this condition?
