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Final clinical long case 47

Created: 29/5/2013
A slightly obese 55-year-old woman with sickle cell disease and a very large goitre presents for elective thyroidectomy. She is biochemically euthyroid.

ECG: sinus tachycardia
Urea & electrolytes: elevated urea and creatinine
Chest X-ray: tracheal narrowing and deviation

1. Summarise the case.
2. Discuss the results of the investigations.
3. What other investigations would you carry out?
4. How would you anaesthetize her?
5. What might be the postoperative complications?
6. How would you manage an airway problem postoperatively?
7. What are the signs of hypocalcaemia?

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