This lady in her forties was brought to me by her father to treat a thyroid swelling. For the past six or more months she had recieved treatment from a physician with partial relief to her symptoms of palpitation and anxiety. He brought this patient to me because I had cured his wife 15 yrs ago of her thyroid swelling (goiter'graves' disease)a after tretment for nearly one and half year. This patient was recieving tablet ciplar 10 mg bid ;methimazole tablet 10 mg od.On physical examination patient was thin built with weight of 42 kg, middle aged lady,with thyroid swelling with nodule appearing at right upper pole medially approximately size of peanut. There was no exophthalmos.
She has tremors seen on arms fully extended. She had pallor ++.there was thyroid bruite heard over goiter. Her sound was normal with no murmur or gallop. Her ecg was showing sinus rythm and heart rate of…
